Abdominal examination revealed tenderness to deep palpation in the upper left quadrant without signs of peritonitis. Physical examination revealed an hematoma previously described and diminished breath sounds in the left side of the thorax. He also had clinical signs of a fracture on his left tibia.When initially seen in the ED, his systolic blood pressure was 130 mmHg and remained stable after 1000 ml bolus of crystalloid, GCS=15, pulse was 88/minute and respiratory rate was 24/minute. Thoracoabdominal transition posteriorly on the left side.
The following case report of a young trauma patient without hemodynamic instability who developed a colonic necrosis in the splenic flexure is presented because of its rarity. Fewcases have been described, most of them due to hipovolemia or hemorrhagic shock (1,3,6). Large bowel necrosis following abdominal trauma in young patients is an unusual condition. Embora rara, esta situação pode ocorrer naqueles doentes inicialmente submetidos a tratamento não operatório após trauma abdominal fechado. Os autores relatam caso raro de um doente do sexo masculino de 28 anos de idade, politraumatizado que desenvolveu necrose da flexura esplênica do cólon devido a trombose da artéria cólica média após 18 horas do traumatismo. Uniterms: Abdominal trauma, colonic necrosis, shock, hemorrhage, arterial thrombosis, intestinal ischemia. Although rare, this condition can occur in those patients whom non surgical treatment was initially performed. We report an unusual case of a 28-year-old man who developed a colonic necrosis due to thrombosis of the middle colic artery 18 hours following blunt abdominal trauma. Raul Coimbra José Ribeiro Aguiar Samir Rasslan Silvio Pires RessurreiçãoĮmergency Service Department Surgery Santa Casa School Medicine - São Paulo - Brazil Colonic (splenic flexure) necrosis due to thrombosis of the middle colic artery following blunt abdominal trauma
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