Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jul 27, 2024; 16(7): 2337-2342
Published online Jul 27, 2024. doi: 10.4240/wjgs.v16.i7.2337
Sequential bowel necrosis and large gastric ulcer in a patient with a ruptured femoral artery: A case report
Peng Wang, Ting-Gang Wang, An-Yong Yu
Peng Wang, Ting-Gang Wang, An-Yong Yu, Department of Emergency, The Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
Author contributions: Wang P wrote the manuscript and prepared the images; Wang TG and Yu AY helped conceive and design the study and to critically revise the manuscript. All authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any ac-companying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: An-Yong Yu, MD, Chief Physician, Department of Emergency, The Affiliated Hospital of Zunyi Medical University, No. 149 Dalian Road, Huichuan District, Zunyi 563000, Guizhou Province, China. anyongyu@163.com
Received: March 12, 2024
Revised: May 28, 2024
Accepted: June 19, 2024
Published online: July 27, 2024
Processing time: 132 Days and 2.2 Hours
Abstract
BACKGROUND

Severe bleeding as a result of a major vascular injury is a potentially fatal event commonly observed in the emergency department. Bowel necrosis and gastric ulcers secondary to ischemia are rare due to their rich blood supply. In this case, we present the case of a patient who was treated successfully following rupture of his femoral artery resulting in bowel necrosis and an unusually large gastric ulcer.

CASE SUMMARY

A 28-year-old male patient sustained a knife stab wound to the right thigh, causing rupture of his femoral artery and leading to massive bleeding. He underwent cardiopulmonary resuscitation and received a large blood transfusion. Abdominal surgeries confirmed bowel necrosis, and jejunostomy was performed. The necrotic intestine was removed, the remaining intestine was anastomosed, and the right thigh was amputated. After three surgeries, the patient's overall condition gradually improved, and the patient was discharged from the hospital. However, one day after discharge, the patient was admitted again due to dizziness and melena, and a gastroduodenoscopy revealed a giant banded ulcer. After 2 weeks of treatment, the ulcer had decreased in size without bleeding. Six months after the last surgery, enterostomy and reintroduction surgery were completed. The patient was fitted with a right lower limb prosthesis one year after surgery. After 3 years of follow-up, the patient did not complain of discomfort.

CONCLUSION

Trauma department physicians need to be aware of the possible serious complications involving the abdomen of trauma patients with massive bleeding.

Keywords: Bowel necrosis; Gastric ulcer; Trauma; Femoral artery rupture; Ischemia; Case report

Core Tip: This report describes a case of sequential bowel necrosis and an unusually large gastric ulcer in a patient with a ruptured femoral artery. We present this case to emphasize the importance of monitoring the abdomen and staying alert for potential complications in severely ill patients with massive blood loss. Physicians should be aware of the possible serious complications of lesions in the abdomen, even if there are no obvious signs of trauma.