Bowel Entrapment by Fragments of Acetabular Fracture -A Case Report-

Ji Wan Kim; Jung Jae Kim; Suk-Kyung Hong; Kyu Hyuk Kyung; Jin Hee Kim

doi:10.12671/jkfs.2010.23.4.373

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Kim, Kim, Hong, Kyung, and Kim: Bowel Entrapment by Fragments of Acetabular Fracture -A Case Report-

Case Report

Journal of the Korean Fracture Society

Journal of the Korean Fracture Society 2010; 23(4): 373-376.

Published online: 31 October 2010

DOI: https://doi.org/10.12671/jkfs.2010.23.4.373

Bowel Entrapment by Fragments of Acetabular Fracture -A Case Report-

Ji Wan Kim, M.D.^‡, Jung Jae Kim, M.D., Suk-Kyung Hong, M.D.^*, Kyu Hyuk Kyung, M.D.^*, Jin Hee Kim, M.D.^†

Department of Orthopaedic Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.

^*Department of Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.

^†Department of Radiology and Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.

^‡Department of Orthopaedic Surgery, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, Korea.

Address reprint requests to: Jung Jae Kim, M.D. Department of Orthopaedic Surgery, College of Medicine, Asan Medical Center, College of Medicine, University of Ulsan, 86, Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, Korea. Tel: 82-2-3010-3530, Fax: 82-2-488-7877, jjkim2@amc.seoul.kr

Received 18 June 2010 Accepted 27 July 2010

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Abdominal injuries are common in patients with pelvic or acetabular fracture. However intestinal entrapment or perforation caused by fragments of a pelvic or acetabular fracture is rare and to date there has been no report of this occurring in Korea so far. As it is difficult to diagnose intestinal entrapment caused by fragments of pelvic or acetabular fracture, the entrapment therefore results in intestinal perforation, sepsis, and a high mortality rate in the absence of early detection. We present a case of intestinal entrapment and perforation caused by fragments of acetabular fracture as well as a literature review.

Keywords: Pelvis, Acetabular fracture, Complication, Bowel entrapment

Figures and Tables

Fig. 1

(A) Initial Pelvis AP view, (B, C) Initial 3D pelvis CT images show both column acetabular fracture with central dislocation. The arrows indicate the fragment protruded medially and superiorly.

Fig. 2

Supine abdomen x-ray shows intestinal dilatation.

Fig. 3

Initial axial image of pelvis CT shows entrapped bowel between fragments of acetabulum (circle).

Fig. 4

(A) Acetabular fragment penentrates retroperitoneum and compress small bowel.

(B) The distal ileum (circle) is perforated.

Fig. 5

Pelvis CT image 4 days after reanastomosis operation shows fluid collection (arrow) around gluteus muscle.

Fig. 6

The 6 months follow up Pelvis AP radiograph shows that acetabular fracture doesn't have union and femoral head migrates medially.

References

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