J Korean Soc Traumatol.  2016 Jun;29(2):56-59. 10.20408/jti.2016.29.2.56.

Simultaneous Surgery on Jejunum perforation with Pelvic Ring Fracture: A Case Report

• Chung H
• Bae KS
• Kim SY
• Kim D

• KMID: 2350941
• DOI: http://doi.org/10.20408/jti.2016.29.2.56

Abstract

Patients with pelvic bone fractures with gastrointestinal perforations are reported in 4.4% of the cases and in very rare cases jejunum (0.15) is involved. However, intestinal perforations are often undiagnosed on the first examination before peritonitis is evident. We are presenting a report where a patient with anteroposterior compression injury, who was expected to undergo an internal fixation procedure, did not show any jejunum perforations on abdominal CT or other physical exams but was found on abdominal CT 1 week after right before surgery, therefore excision and anastomosis surgery, pelvic open reduction and internal fixation was simultaneously done with favorable results. In our case, we present a 61 year old male patient with liver trauma, adhesion at the abdominal cavity, with a past history of gallbladder excision, but without abdominal pain, fever, or infection symptoms. Therefore, this was a case that was difficult to initially diagnose the patient with jejunum perforation and peritonitis. The diagnosis was further supported during laparotomy when peritonitis around the area of intestinal perforation was observed. Generally, it is understood that pelvic bone fracture surgery is not immediately done on patients with peritonitis. However, this kind of patient who had peritonitis with intestinal adhesion and other complications could undergo surgery immediately as infection or other related symptoms did not coexist and the patient was rather stable, and as a result the treatment was successful.

Keyword

Pelvic ring injury; Jejunum perforation; Abdominal-pelvic trauma

MeSH Terms

Abdominal Cavity
Abdominal Pain
Diagnosis
Fever
Gallbladder
Humans
Intestinal Perforation
Jejunum*
Laparotomy
Liver
Male
Pelvic Bones
Peritonitis
Tomography, X-Ray Computed