2015 Volume 35 Issue 7 Pages 917-920
A 48-year-old man who had suffered abdominal trauma was transported to our emergency room by ambulance. On arrival, his vital signs suggested shock. He responded to initial infusion. Contrast enhanced computed tomography was performed. An intra-abdominal hemorrhage was diagnosed due to superior mesenteric artery (SMA) injury. The patient’s blood pressure decreased again, and emergency surgery was judged to be necessary. However, there was a delay before the operation could be performed. The root of the SMA was occluded with a balloon catheter, and then open hemostasis was performed. Extensive mesenteric injury involving the retroperitoneum and the SMA was noted. Hemostasis was achieved by suturing as soon as possible, and the portion of the intestinal tract with poor blood flow was resected. The wound was closed after gauze packing. Three days later, laparotomy was performed again for a colostomy. Ten months later, the patient underwent colostomy closure. With SMA occlusion, the hemorrhage noted before laparotomy was successfully controlled, and long-term placement was possible without reperfusion injury or ischemic injury of other organs. In addition, the minimum blood flow in the region of the SMA except for the injured area was considered to have been successfully maintained.
