Intestinal Stenosis From Mesenteric Injury After Blunt Abdominal Trauma in Children: Case Reports

The incidence of mesenteric injury after blunt abdominal trauma (BAT) has increased in recent years, however, relatively little attention has been paid to instances of its sequels, especially in childhood. We present three children who had post-traumatic intestinal stenosis (PIS). A history of BAT was obtained in all. They had abdominal pain, bilious vomiting and peritoneal signs. The time intervals, the duration from the initial trauma to the onset of symptoms, ranged from 23 to 62 days. Stenotic segments were parallel to the location of the previously recognized mesenteric hematoma (MH) and resection with primary anatomosis was performed. Pathological examinations of subjects confirmed mucosal and mural ischemia, and full-thickness fibrosis of the intestinal wall. In our opinion, large MH may pose an increasing risk of narrowing in the adjacent intestine at different time periods. Therefore, if there is a large MH at laparotomy after BAT, it should be evacuated and bleeding halted. For the differential diagnosis, typical BAT should be carefully investigated in cases presenting with intermittent colic abdominal pain and/or partial intestinal obstruction findings.