Abstract Introduction We present the case of an 18-year-old male admitted to the emergency department after a high-speed motor vehicle collision. The patient showed signs of possible chest and abdominal trauma. This manuscript details his clinical course and management, along with a review of the literature on mesenteric root hematoma. Case Presentation Upon admission, the patient was conscious with stable vital signs. A polytrauma CT scan revealed cervical and thoracic spine fractures, a splenic laceration, and significant intra-abdominal hematomas, including one involving the mesenteric root. He underwent urgent laparotomy due to high suspicion of associated hollow viscus injury and significant hemoperitoneum. Procedures included a splenectomy for a massive splenic rupture, an omentectomy due to devitalized omental lacerations and suturing of mesenteric lacerations. The mesenteric root hematoma was managed with intraoperative non-exploration and temporary packing. Results The patient’s postoperative course was uneventful. He remained hemodynamically stable, maintained normal hemoglobin levels, and showed no signs of infection. He was discharged in good condition on the eighth postoperative day, with no abdominal pain, bowel dysfunction, or wound complications. Conclusion This case highlights the complexity of decision-making in polytrauma patients with associated mesenteric injuries. It emphasizes the importance of balancing the risks of surgery against the potential benefits of conservative management in cases of mesenteric hematoma. The positive outcome underscores the value of sound clinical judgment and comprehensive supportive care in trauma settings.
Dubovský et al. (Tue,) studied this question.
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