Ileosigmoid fistula and delayed ileal obstruction secondary to blunt abdominal trauma: a case report

Abstract

IntroductionAbdominal trauma is a source of significant mortality and morbidity. Bowel injury as a result of blunt abdominal trauma is usually evident within hours or days of the accident.Case presentationA 38-year-old Caucasian Greek man presented with a subtle and delayed small bowel obstruction caused by a post-traumatic ileosigmoid fistula and ileal stricture four months after a road traffic accident.ConclusionDelayed occurrence of post-traumatic small bowel stricture and ileosigmoid fistula is an uncommon surgical emergency. General surgeons as well as emergency physicians should bear this manifestation in mind should a patient return to the hospital several weeks or even years after blunt abdominal trauma with symptoms or signs of bowel obstruction.

Delayed bowel obstruction after seat belt injury: a case report

“…To date, most data with beneficial effects are from case reports or observational studies that enrolled a limited number of patients. The presence of free intraperitoneal fluid in the abdomen is not observed in stable patients [11]. Open surgery has been the preferred method for surgical treatment of strangulating adhesive SBO and SBO that is refractory to conservative management.…”

Small bowel stenosis following blunt abdominal trauma: a case report

“…Abdomen is the third most commonly injured body part following trauma and 85% cases are blunt abdominal trauma . Solid organs such as liver and spleen are the most frequently injured organs.…”

Complex ileo‐caeco‐sigmoid fistula: a rare cause of small bowel obstruction

“…Most of the external fistulas are seen in the post‐operative period after abdominal surgeries. The common causes of internal GI fistulas include Crohn’s disease (CD), cancer, diverticulitis, iatrogenic injuries and trauma . The most common sites for internal GI fistulas are ileosigmoid, caecosigmoid, ileoileal and ileojejunal .…”

“…The treatment of internal GI fistula depends upon its aetiology. Resection of the fistula with re‐establishment of the GI continuity is the preferred treatment in most cases . However, if the cause of internal GI fistula is determined by biopsy such as CD and tuberculosis, then the patients can be offered medical therapy if the bowel complications such as obstruction, perforation and bleeding are absent.…”

“…The common causes of internal GI fistulas include Crohn's disease (CD), cancer, diverticulitis, iatrogenic injuries and trauma. [1][2][3][4][5][6] The most common sites for internal GI fistulas are ileosigmoid, caecosigmoid, ileoileal and ileojejunal. [1][2][3][4][5][6] Rarely, primary GI fistula that communicate with the other organs have also been described.…”