Traumatic 'degloving' of the colon in blunt abdominal injury

A rare case of steering wheel injury causing coronal-plane pancreatic lacerations

The incidence of pancreatic injury after blunt abdominal trauma is extremely low. A timely and accurate diagnosis is important, as a delay could be life-threatening. In this case, a 70-year-old driver crashed a car into a concrete wall at low speed. He was transported to the emergency hospital but died about 9.5h later with the cause of death unknown. An autopsy revealed that his pancreas was lacerated in the coronal plane and there was mesenteric contusion. Cause of death was determined to be blood loss resulting from pancreatic and mesenteric contusion. The mechanism of the injury was considered to be a very rare "degloving," caused by the impact from the steering wheel. It is therefore important to keep in mind possible pancreatic damage when examining blunt trauma to the abdomen, especially in traffic accident cases.

Degloving Injury of Bowel: An Unheard Complication of Surgical Abortion

Unsafe abortion is one of the leading causes of maternal mortality. Various types of intestinal injury in form of haematoma, perforation, contusion and transection have been reported. Degloving injury of intestine is one of the rarest complications. We report a case of 32-year-old lady Gravida 4, para 3 admitted with history of induced surgical abortion by a quack with degloving injury to bowel. Though there was no fecal soiling of peritoneal cavity but large segment of bowel was lost. She was managed by end ileostomy and discharged in stable condition.

A case of degloving injury of the colon

The left side of a truck driven by a 71-year-old man was hit by another car at an intersection, and his abdomen was compressed by the steering wheel. On arrival, he complained of severe lower abdominal pain; and physical examination demonstrated involuntary rigidity and rebound tenderness. Enhanced truncal computed tomography exhibited that the descending colon was shifted ventral and medial because of a low-density mass with contrast extravasation. An emergency laparotomy disclosed injuries of the descending colon, which could be mobile because of degloving of the colon, left mesenterium, spleen, and tail of pancreas. During resection of these injured organs, difficulty in controlling the bleeding from the degloving injury site resulted in the requirement of a “second look” operation. The postoperative course was eventful; however, the patient's physiologic condition stabilized, and he was discharged on foot on the 108th hospital day.

A case of thoracic degloving injury with flail chest

A 75-year-old male patient suffered a chest degloving injury when he fell on his back and was run over by a small farm tractor he was pulling. At the time of patient admission, the paradoxical motion of the right chest wall was remarkable; and he had an open fracture of the right humerus, a dislocation of the right ankle, and a laceration of the right forearm. Chest computed tomography revealed fractures of the fifth to seventh ribs and detachment of both the right pectoralis major muscle and serratus anterior muscle from the chest wall, with a disconnected right thoracic cavity. Because the right flail chest was severe and there was a large amount of air leakage that continued under positive-pressure ventilation for pneumatic stabilization, we performed surgical fixation of the ribs and repaired the lung injury on the fifth hospital day. The patient's postoperative course was uneventful.