Hyperextension Lumbar Injury Resulting in Intervertebral Bowel Entrapment: A Case Report
Mayol-del Valle, M.A.; Fernandez-de Thomas, R.J.; Santacana-Laffitte, G.; Corona, J.M.; Martinez, F.; Canario Brea, Q.; Saavedra-Pozo, F.M.; Inserni, J.
Boletin de la Asociacion Medica de Puerto Rico 109(1): 53-55
2017
ISSN/ISBN: 0004-4849 Document Number: 703068
We report the case of bowel entrapment in vertebrae after a motor vehicle accident in a 42-year-old man who presented with acute abdominal pain. Trauma workup was performed, an L2 Chance fracture was identified, and a thoracolumbar MRI was performed to assess neural involvement. Since abdominal pain persisted, an exploratory laparotomy was performed. On exposure of abdominal contents, the small bowel was followed and noted to "disappear" in the lesser sac. Bowel was found entrapped and necrotic within the intervertebral disc space at L1-L2. This cause for mechanical bowel obstruction is rare and constitutes a diagnostic challenge. It is important for all Trauma surgeons and radiologists to be aware of the possibility of intervertebral impingement as the cause of mechanical bowel obstruction. Hyperextension/flexion injury may be an uncommon cause of persisting abdominal pain; therefore, it should be considered in the initial differential diagnosis.
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