Sequential bowel necrosis and large gastric ulcer in a patient with a ruptured femoral artery: A case report

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.