Abstract
We report a rescued case of a female, age19, with intraperitoneal hemorrhage caused by blunt abdominal trauma. Splenectomy and ligation of the superior mesenteric artery and vein with intra-abdominal packing were first undertaken. After the hemodynamics were recovered in the ICU, we performed angiography to evaluate the intestinal blood supply. Angiography revealed complete disruption of the SMA and the first jejunal branch was not detected. Enhanced CT showed a contrast failure of the jejunum. We performed a second look operation 48 hours later. The jejunum was found to be necrotic more than 10cm from the Treiz ligament. Therefore, we resected 120cm of the jejunum and performed functional end-to-end anastomosis. The patient recovered from passage disorder of the duodenum due to pancreatic edema within three weeks, and was discharged on the 35th postoperative day. Chronic body weight loss due to diarrhea was improved two years later.
