Abstract
A 48-year-old man, a restrained passenger involved in a vehicle accident, was transferred to our hospital. The physical examination indicated mild abdominal tenderness over the upper abdomen. Abdominal CT showed a small mesenteric hematoma around the transverse colon and a small amount of free intraperitoneal fluid without any free air or thickening of the colon wall. Therefore, the patient was admitted to our hospital and placed under observation for his abdominal tenderness. On admission, he was afebrile and his abdominal pain remained the same. The follow-up abdominal CT performed the next day indicated thickening of a limited part of the transverse colon. We decided to perform a diagnostic laparoscopy. The laparoscopy revealed that the mesentery of the transverse colon was injured, and a limited part of the transverse colon was found to be devascularized and necrotic. Thereafter, a laparotomy was performed in which the devascularized bowel was resected, and an anastomosis of the healthy bowel was performed to maintain continuity. The postoperative course was uneventful except for a mild wound infection, and the patient left the hospital on day 20 after admission. We conclude that diagnostic laparoscopy may be safe and useful even in some cases of blunt abdominal trauma.
