The left side of a truck driven by a 71-year-old man was hit by another car at an intersection, and his abdomen was compressed by the steering wheel. On arrival, he complained of severe lower abdominal pain; and physical examination demonstrated involuntary rigidity and rebound tenderness. Enhanced truncal computed tomography exhibited that the descending colon was shifted ventral and medial because of a low-density mass with contrast extravasation. An emergency laparotomy disclosed injuries of the descending colon, which could be mobile because of degloving of the colon, left mesenterium, spleen, and tail of pancreas. During resection of these injured organs, difficulty in controlling the bleeding from the degloving injury site resulted in the requirement of a “second look” operation. The postoperative course was eventful; however, the patient's physiologic condition stabilized, and he was discharged on foot on the 108th hospital day.
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http://dx.doi.org/10.1016/j.ajem.2010.09.034 | DOI Listing |
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