Entrapment of Bowel Within a Spinal Fracture

Rodger, Robyn; Missiuna, Paul; Ein, Sigmund H.

doi:10.1097/01241398-199111000-00017

Cited by 17 publications

(23 citation statements)

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“…Nowadays two theories are proposed. According to some authors, an anterior force pushes the bowel while other authors explain the bowel incarceration by a posterior vacuum responsible of a traction force[ 6 - 11 ]. In our case, the findings support the concept that the anterior dislocation of the L3 vertebra tore up the posterior peritoneum and brought back the jejunum loop in the spinal canal.…”

Section: Discussionmentioning

confidence: 99%

Small bowel entrapment and ureteropelvic junction disruption associated with L3 Chance fracture-dislocation

Pesenti¹,

Blondel²,

Faure³

et al. 2016

WJCC

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Paediatric Chance fracture are rare lesions but often associated with abdominal injuries. We herein present the case of a seven years old patient who sustained an entrapment of small bowel and an ureteropelvic disruption associated with a Chance fracture and spine dislocation following a traffic accident. Initial X-rays and computed tomographic (CT) scan showed a Chance fracture with dislocation of L3 vertebra, with an incarceration of a small bowel loop in the spinal canal and a complete section of the left lumbar ureter. Paraplegia was noticed on the initial neurological examination. A posterior L2-L4 osteosynthesis was performed firstly. In a second time she underwent a sus umbilical laparotomy to release the incarcerated jejunum loop in the spinal canal. An end-to-end anastomosis was performed on a JJ probe to suture the left injured ureter. One month after the traumatism, she started to complain of severe headaches related to a leakage of cerebrospinalis fluid. Three months after the traumatism there was a clear regression of the leakage. One year after the trauma, an anterior intervertebral fusion was done. At final follow-up, no neurologic recovery was noticed. In case of Chance fracture, all physicians should think about abdominal injuries even if the patient is asymptomatic. Initial abdominal CT scan and magnetic resonance imaging provide in such case crucial info for management of the spine and the associated lesions.

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Section: Discussionmentioning

confidence: 99%

Small bowel entrapment and ureteropelvic junction disruption associated with L3 Chance fracture-dislocation

Pesenti¹,

Blondel²,

Faure³

et al. 2016

WJCC

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“…The cases of traumatic jejunal entrapment have been previously reported in the literature [1,2,3,4,5,6,7,8,9,11]: 2 cases occurred in adults and 8 in children.There has been no report on this injury in patients with rheumatoid spondylitis (Bechterew arthritis).…”

Section: Traumatic Jejunal Entrapment In a Patient With Rheumatoid Spmentioning

confidence: 92%

“…Llumbar spine fracture · M.Bechterew · Jejunum incarceration kuum scheint bei der Jejunumeinklemmung eine zentrale Rolle zu spielen [2,6,8,10].Manche Forscher behaupten,dass das Jejunum durch den erhöhten intraabdominellen Druck in die Lücke zwischen die Lumbalwirbel gedrückt wird [9,11].…”

Section: Introductionunclassified

“…In der Mehrzahl der bisher beschriebenen Fallbeispiele war der Zeitraum zwischen dem Trauma, korrekter Diagnose und Therapie zu lang; in manchen Fällen betrug er 3 [2,11] bis 13 Tage [8].Anzeichen und Symptome eines paralytischen Ileus neigen dazu, sich schrittweise zu entwickeln. Bei unserem Patienten wurde die Verletzung im Vergleich zu vorher beschriebenen Fallbeispielen [1,3,4,5,7] …”

Section: Introductionunclassified

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Traumatische Jejunumeinklemmung bei einem Patienten mit M. Bechterew

et al. 2002

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We report an unusual case of incarceration of small bowel between the 4th and 5th lumbar vertebrae in a patient with rheumatoid spondylitis. Incarceration of the loop of jejunum within the fracture or between dislocated lumbar vertebrae is an uncommon entity. The cases of traumatic jejunal entrapment have been previously reported in the literature [1, 2, 3, 4, 5, 6, 7, 8, 9, 11]: 2 cases occurred in adults and 8 in children. There has been no report on this injury in patients with rheumatoid spondylitis (Bechterew arthritis).

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“…The invagination of peritoneal or retroperitoneal structures into the lumbar intervertebral disc space rarely occurs. A dozen cases of intervertebral invagination of intra-abdominal structures, such as the intestine, vena cava, iliac vessels, the torn redundant anterior longitudinal ligament (ALL), retroperitoneal fat, and the psoas muscle have been reported [1][2][3][4]. Usually, invagination of peritoneal or retroperitoneal structures into the lumbar intervertebral disc space are induced by acute trauma.…”

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confidence: 99%

“Nature Abhors a Vaccuum”: Invagination of the Small Intestine into the Lumbar Disc Space After a Spinal Fusion Operation

et al. 2020

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A 77-year-old woman having back pain due to an L2 vertebral body compression fracture took a lumbar spine magnetic resonance imaging (MRI). In MRI, in addition to the L2 vertebral body fracture, invagination of the small intestine into the intervertebral disc space at L5-S1 was found by chance. On a lateral lumbar spinal X-ray, the lordotic angle was markedly increased at the L5-S1 level. Additionally, the L5-S1 disc space had widened. These X-ray findings indicate the segmental instability at L5-S1. The spinal fusion operation on L3-4-5 seems to have resulted in overt mechanical loading on the inferior spinal segment (L5-S1). We think the instability damaged the anterior longitudinal ligament and caused a tear in the anterior portion of the annulus fibrosus. The defect in the L5-S1 intervertebral disc after the tear would have caused the vacuum, which is presumed to have pulled the patient’s small intestine into the empty space within the L5-S1 intervertebral disc. Although intervertebral invagination of intra-abdominal structures is not common, clinicians should be aware of the possibility of this complication in patients who have spinal segmental instability.

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Entrapment of Bowel Within a Spinal Fracture

Cited by 17 publications

References 0 publications

Small bowel entrapment and ureteropelvic junction disruption associated with L3 Chance fracture-dislocation

Small bowel entrapment and ureteropelvic junction disruption associated with L3 Chance fracture-dislocation

Traumatische Jejunumeinklemmung bei einem Patienten mit M. Bechterew

“Nature Abhors a Vaccuum”: Invagination of the Small Intestine into the Lumbar Disc Space After a Spinal Fusion Operation

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