An atypical presentation of mesenteric bucket-handle injury following direct trauma during football: a case report

Mesenteric bucket-handle injuries are critical abdominal traumas typically associated with high-impact deceleration mechanisms. This case report describes an atypical presentation involving a 32-year-old healthy male who sustained a direct knee impact during a football match. Initially discharged due to a perceived low-risk mechanism, the patient returned three days later with signs of small bowel obstruction. Diagnostic imaging suggested internal herniation, and surgical exploration revealed a segment of ischemic herniated bowel within a large mesenteric bucket-handle defect. The patient underwent bowel resection with anastomosis and primary repair of the mesenteric defect, resulting in an uneventful recovery. This case underscores the diagnostic challenges of low-energy mechanisms and atypical radiological findings. It emphasizes the need for a high index of clinical suspicion in blunt abdominal trauma to prevent delayed diagnosis and serious ischemic complications.