Penetrating Trauma Resulting in Strangulated Small Bowel Evisceration: A Case report

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Abstract Introduction : Evisceration of the small intestine following a stab wound is a rare and life-threatening complication resulting from severe abdominal trauma. This case report presents the clinical experience of a patient with small intestine evisceration after a stab wound, providing valuable insights into clinical manifestations, management, and care outcomes of this exceptional condition. Case report We present the case of a 24-year-old patient who was the victim of a penetrating trauma, leading to the strangulated evisceration of a segment of the small bowel. Upon clinical examination revealed a right flank abdominal wound as the site of strangulated small bowel evisceration. Given these clinical findings, the decision to perform an immediate exploratory laparotomy was imperative. A midline incision was made, and an exploratory laparotomy was performed. The strangulated bowel segment was well perfused, and no additional digestive lesions were identified. Consequently, abdominal lavage was carried out. The patient's postoperative course was uneventful, and the patient was discharged on the third day after surgery. Discussion: This case report emphasizes the urgency and significance of immediate surgical intervention in post-traumatic strangulated small bowel evisceration, particularly in cases involving sharp object injuries. The rarity of this condition should not undermine its critical nature, necessitating a meticulous clinical examination for timely assessment. Laboratory and radiological tests should not delay emergency surgery, considering the time sensitivity and potential consequences like intestinal necrosis. The choice between laparotomy and laparoscopy depends on the nature and severity of the injury, with laparoscopy offering diagnostic and therapeutic benefits in select cases. Overall, this case underscores the life-saving potential of prompt surgical intervention in managing this challenging condition Conclusion Post-traumatic strangulated small bowel evisceration represents a potentially grave condition. Nevertheless, prognosis primarily hinges on the severity of accompanying injuries. In cases of isolated post-traumatic strangulated small bowel evisceration, a favorable outcome can be achieved with prompt and appropriate intervention, involving immediate emergency laparotomy to address strangulation and perform a thorough evaluation of injuries.

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