Mesenteric “Bucket Handle Tear” After Run Over Accident: A Case Report

Introduction:Intestinal and mesenteric injuries are less common than solid organ injuries around 3–5 % and due to the diagnostic dilemma they can result in therapeutic delay and undiagnosed complications are severe with high mortality rates. They are third in order of frequency after liver and splenic injury. -eFAST is not enough for diagnosis of Intestinal and mesenteric injuries. -Lapar Aims & Objectives: otomy should be done for hemodynamically unstable patient in high velocity blunt trauma abdomen with positive clinical ndings. -Interventional dilemma may cause patient's life. 24 year male, involved in a vehicular run over accident, arrived 2h after the accide Discussion: nt in hemodynamically unstable condition. Diffuse abdominal tenderness present. eFAST showed chink of free uid collection in perisplenic area ONLY Even after resuscitation, patient remained hemodynamically unstable and an urgent Laparotomy was performed. “Bucket Handle Tears” of the mesentery were found. Enterectomy was performed and end-to-end hand sewn anastomosis done.Mild postoperative complications were recorded but patient was discharged after 18 days. 1, 3 & 6 month's follow-up, patient is without any complications. Small intestinal injuries constitute more than half of all intestinal injuries. It should be suspected in all high energy traumas. eFAST is not useful for the diagnosis. Laparotomy is the standard of care in hemodynamically unstable patients. Patient prognosis is affected by the delay of therapeutic intervention. If we have Conclusion: hemodynamically unstable patient with abdominal tenderness and features of peritonism then it is better to think for exploratory laparotomy as soon as possible rather to wait and watch.