Abstract
Small bowel obstruction due to blunt abdominal trauma is rare. A 75-year-old male, who had undergone a total gastrectomy for gastric cancer eight years previously, received blunt trauma to his left lateral abdomen during an accident. Five days after injury, he consulted our hospital for abdominal pain and a left hypochondrial tumor. Abdominal CT examination revealed an intra-mesenteric hematoma and reverse rotation of the mesenteric artery and vein. As all other data such as blood analysis and abdominal plain films showed normal findings and the clinical symptom was slight, conservative treatment was performed. His symptom, however, persisted. Diagnostic laparoscopy showed torsion of the small intestine around the jejuno-abdominal adhesion, and laparoscopic manipulation of torsion and lysis of the adhesion were performed. Abdominal CT examination is useful for diagnosis, and instead of open laparotomy, laparoscopy can be used safely and effectively for the diagnosis and treatment of traumatic abdominal injury.
