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J Trauma Inj > Volume 29(2); 2016 > Article
Journal of Trauma and Injury 2016;29(2):56-59.
DOI: https://doi.org/10.20408/jti.2016.29.2.56    Published online June 30, 2016.
Simultaneous Surgery on Jejunum perforation with Pelvic Ring Fracture: A Case Report
Hoejeong Chung, Keum Seok Bae, Seong Yup Kim, Doosup Kim
1Department of Orthopaedic Surgery, Wonju College of Medicine, Yonsei University, Gangwon-do, Korea. ami0301@hanmail.net
2Department of General Surgery, Wonju College of Medicine, Yonsei University, Gangwon-do, Korea.
Received: 21 May 2016   • Revised: 16 June 2016   • Accepted: 4 July 2016
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.
Key Words: Pelvic ring injury; Jejunum perforation; Abdominal-pelvic trauma


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