Small Bowel Avulsion from a Fall

A Case Report

บทคัดย่อ

A 7 year-old boy presented with abdominal pain 4 days after falling from a tree 4 days prior to admission. Physical examination revealed marked dehydration, fever and peritonitis. The patient underwent laparotomy which revealed avulsion and twisting of terminal ilium, ischemia and dilatation of the ilium (about 50% of small bowel length), infected ascites about 1,500 ml. The avulsion was reanastomosed. A second look operation was performed 48 hours later, revealing only 3 feet of gangrenous terminal ilium, resection and end to end anastomosis was done. Recovery was almost uneventful, only a wound infection was encountered.