MULTIVISCERAL PENETRATING TRAUMA: SURGICAL MANAGEMENT FROM TRACHEA TO COLON rita.banza@chleiria.min-saude.pt

PE108

MULTIVISCERAL PENETRATING TRAUMA: SURGICAL MANAGEMENT FROM TRACHEA TO COLON

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Portugal

Poster Exhibition only

Penetrating cervical and abdominal wounds present with significant clinical challenges due to the anatomical complexity of these regions and the high risk of injury to vital structures. Penetrating neck injuries are associated with high morbidity and mortality due to vascular or aerodigestive tract injury. In the abdominal region, the most commonly affected organs are the liver, small intestine, diaphragm and the colon.

This report describes a case of a 26-year-old male, who presented to the emergency room with stab wounds to the cervical, thoracic and abdominal regions. Upon assessment, the patient presented with airway compromise and hemodynamic instability due to a penetrating cervical injury with active hemorrhage and tracheal injury, a superficial wound to the left hemithorax, and a penetrating abdominal injury with small bowel evisceration. After initial stabilization and hemorrhage control, the patient underwent emergent surgical exploration. In the operating room, the patient was diagnosed with multiple perforations of the small bowel and colon, transection of the right ureter, injury to the right psoas muscle, and an anterior partial transection of the trachea. Surgical procedures included small bowel resection with anastomosis, primary repair of the colon, ureteral stent placement with ureteral reconstruction, and tracheal suture.

The postoperative course was uneventful, and the patient was discharged on the 8th postoperative day.

These injuries require immediate evaluation and stabilization by a multidisciplinary team, as they may pose life-threatening conditions and necessitate emergent surgical intervention. A high index of suspicion is essential during surgical exploration to avoid missing any injuries.