A 36-year-old male presented after a road traffic accident (RTA) with blunt abdomen injury and a right tibiofibular fracture. He has the pulse of 72/min and blood pressure (BP) of 112/70 mm Hg with a normal FAST exam. The patient was transferred to the orthopedic unit for further management but developed complaints of vomiting and constipation with abdominal distension over the next 3 days. Abdominal X-ray [] revealed multiple air fluid levels and a contrast CT with oral and intravenous (IV) contrast revealed an obstruction at the jejunoileal junction. A decision was taken to do a diagnostic laparoscopy on day 4 after injury, which was converted to open laparotomy due to findings of internal herniation of ileal loops through the transverse mesocolon. This herniated ileal loop had vascular compromise so it was resected, and an ileo-ileal end to end anastomosis was done. The postoperative period was uneventful, and the patient was discharged on postoperative day 7.
A 35-year-old male presented with blunt abdominal trauma after an RTA along with injury to left lower limb. His hemodynamic parameters were normal, with a pulse of 100/min and a BP of 110/70 mm Hg. He had generalized abdominal tenderness and guarding. The FAST exam was positive, and X-ray revealed a left shaft of femur fracture. CT with IV contrast revealed no enhancement in both kidneys in the arterial phase suggestive of bilateral renal pedicle injury []. Endovascular stenting of both renal arteries was attempted unsuccessfully the next day after injury. Laparotomy was done 2 days after the injury due to the failure of endovascular stenting, and a right aortorenal artery polytetrafluoroethylene grafting was done on the right side. On the left side, a splenectomy was done, and the splenic artery anastomosed with the left renal artery. Patient underwent repeated dialysis in the postoperative period. His urine output returned to normal but after 4 days, he succumbed due to his injury. summarizes all the cases.