Delayed small bowel obstruction due to blunt abdominal trauma with mesenteric injury: a case report

Small bowel obstruction (SBO) following blunt abdominal trauma (BAT) is an uncommon but important delayed complication, usually resulting from ischemic or fibrotic changes secondary to mesenteric injury. A 52-year-old male presented 2 months after BAT with a 5-day history of progressive bowel obstruction. Computed tomography imaging showed a 10-cm distal ileal stenosis with mural thickening and mesenteric hyperemia. Exploratory laparotomy revealed a 4-cm ileal thickening and mesenteric laceration. A 20-cm ileal resection with latero-lateral isoperistaltic anastomosis was performed. Histology confirmed ischemic injury secondary to local trauma. This case illustrates a rare presentation of delayed SBO due to post-traumatic mesenteric ischemia. Clinicians should maintain a high index of suspicion in patients with prior BAT and evolving gastrointestinal symptoms to ensure timely diagnosis and management.