Sagui-de FL, Álvarez-Barragán AF, Gaytán-Montoya SS, Rangel-Rodarte R, Román-Sandoval JJ, Schumm-Espino ÁR

Language: Spanish
References: 20
Page: 44-48
PDF size: 218.04 Kb.

ABSTRACT

Introduction: the intestine is the third most injured viscus by blunt trauma, with an incidence of 3.1 to 5%, increasing to 34% if there are injuries to 3 or more solid organs. Intestinal perforations and tears in patients with inguinal hernia after blunt abdominal trauma are rare, occurring in 16% of lesions, and representing a diagnostic challenge. The most common mechanisms of injury are crushing, tearing, avulsion, or bursting. Case report: an 86-year-old male patient who came to the emergency room due to abdominal pain of 8 hours of evolution after a fall from his own height, with blunt trauma to the abdomen and pelvis. Abdominal ultrasound showed free perihepatic and perisplenic fluid, computed tomography was performed with a report of pneumoperitoneum and omental content in the left inguinal hernia, diagnostic laparoscopy was performed with the finding of ileal perforation with eversion of more than 50% of the mucosa. Intestinal resection with anastomosis was performed, leaving the inguinal hernia repair for later due to contaminated abdomen. Conclusions: the opportune diagnosis of hollow organ injury continues to be a challenge in blunt abdominal trauma, the joint presence of inguinal hernia in the patient with trauma increases the risk of intestinal injury. It shows the advantages of laparoscopy in these situations and serves to discuss the therapeutic options for both intestinal perforation and inguinal hernias with contaminated abdomen.

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