In car accidents, there can be many cases of blunt abdominal trauma. One study looked at an isolated jejunal tear in a 24 year old male trucker who exhibited abdominal pain after sustaining blunt abdominal trauma after hitting the steering wheel in an accident. The treating physician missed the isolated jejunal tear and a nearby contusion and secondary tear so conservative care was recommended. He gradually deteriorated and died from his injury. The autopsy showed the jejunal tear in the small bowel with secondary peritonitis. An exploratory laparotomy and special x-rays would have uncovered the problem and he would likely have survived his injuries.
Another study looked at the pattern of small bowel mesenteric injuries caused by contact with the steering wheel during a motor vehicle. They recognized that small gut mesenteric injuries were rare after blunt abdominal trauma from steering wheels. The researchers did a 10 year retrospective study on these types of injury. They found that all such injuries occurred in males with 13 jejunal mesenteric injuries and four ileal mesenteric injuries.
They concluded by acknowledging that these are rare injuries and that tears in the tissue could be longitudinal or transverse. Suture repair is necessary and these patients need to get to a tertiary care facility because a delay in treatment can increase morbidity and mortality. While rare, these types of injuries should be considered when the individual sustains a blunt trauma with a steering wheel in a motor vehicle accident.
In a case study, a researcher looked at a report of a patient who sustained a bowel infarction from abdominal blunt trauma in a car accident. The patient had a bowel resection surgery and survived the injury. This researcher also noted that there needed to be a prompt diagnosis of the problem so the problem can be treated before the patient becomes septic and dies. They recommend a diagnostic peritoneal lavage as a good screening tool for these types of injuries as well as an exploratory laparotomy.
If you or someone you love has been in a trucking or automobile accident, call me now at 916-921-6400.