{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T18:23:30Z","timestamp":1794248610746,"version":"4.9.0"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","license":[{"start":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T00:00:00Z","timestamp":1742515200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,3,21]]},"abstract":"<jats:sec>\n                    <jats:title>Rationale:<\/jats:title>\n                    <jats:p>Isolated mesenteric injury often results from traffic accidents causing blunt abdominal trauma, exhibit nonspecific symptoms and signs. Most mesenteric injuries occur concurrently with injuries to other organs, such as the liver and spleen. As a result, the incidence of isolated mesenteric injury is very low and often misdiagnosed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient concerns:<\/jats:title>\n                    <jats:p>A 49-year-old male patient presented with abdominal pain following a traffic accident more than 5 hours before admission. Upon admission, his blood pressure was normal but dropped sharply in a short time and presented with shock. Anemia, abrasions in the upper abdomen, cold skin on the dorsum of the foot, rebound pain, muscle tension, and noncoagulation of abdominal blood were all observed during the physical examination. Emergency plain and contrast-enhanced abdominal computed tomography (CT), and mesenteric artery CT angiography revealed a large volume of blood accumulated in the abdomen, pelvis, and jejunal mesentery. The jejunal wall and mesentery were edematous, with mesenteric distortion, and some branches of the inner jejunal artery were not clearly visualized. We found no evidence of liver or splenic rupture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Diagnoses:<\/jats:title>\n                    <jats:p>Mesenteric injury of the jejunum caused acute hemorrhagic anemia and hemorrhagic shock.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions:<\/jats:title>\n                    <jats:p>An emergency laparotomy was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes:<\/jats:title>\n                    <jats:p>An emergency laparotomy showed 3 hematomas close to the perforation site, 2 fully split tears in the jejunal mesentery, bleeding from partially exposed veins, a significant amount of blood and clots in the abdominal cavity, and serosal damage at the jejunal mesentery\u2019s root. The patient recovered well after we performed abdominal cavity drainage and jejunal mesenteric hemostasis and repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Lessons:<\/jats:title>\n                    <jats:p>Isolated mesenteric injuries are very rare in clinical practice, and their clinical symptoms and signs are nonspecific, which makes them prone to misdiagnosis and oversight. When a patient satisfies the 4 requirements listed below: abdominal hemorrhage or hematoma; a history of abdominal trauma; no damage to high-risk organs like the liver or spleen; the CT-detected signs of mesenteric injury. Abdominal paracentesis or laparoscopy should be conducted to confirm the diagnosis and initiate further treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/md.0000000000041920","type":"journal-article","created":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T01:09:04Z","timestamp":1743037744000},"page":"e41920","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Abdominal bleeding secondary to isolated mesenteric injury following blunt abdominal trauma: A case report"],"prefix":"10.1097","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7106-7177","authenticated-orcid":false,"given":"Zhiqiang","family":"Ming","sequence":"first","affiliation":[{"name":"Department of Radiology, Zigong First People\u2019s Hospital, Zigong, Sichuan Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Zigong First People\u2019s Hospital, Zigong, Sichuan Province, China"},{"name":"Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Radiology, Zigong First People\u2019s Hospital, Zigong, Sichuan Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongtao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Zigong First People\u2019s Hospital, Zigong, Sichuan Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoli","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Zigong First People\u2019s Hospital, Zigong, Sichuan Province, China."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20261109","doi-asserted-by":"crossref","first-page":"142","DOI":"10.14744\/tjtes.2024.65357","article-title":"A case of seatbelt-induced mesenteric injury and delayed colon ischemia after a car accident.","volume":"30","author":"\u00c7elik","year":"2024","journal-title":"Ulus Travma Acil Cerrahi Derg"},{"key":"R2-20261109","doi-asserted-by":"crossref","first-page":"381","DOI":"10.4103\/jiaps.jiaps_40_21","article-title":"Mesenteric injury in blunt abdominal trauma in children: is early surgical intervention need of the hour.","volume":"27","author":"Singh","year":"2022","journal-title":"J Indian Assoc Pediatr Surg"},{"key":"R3-20261109","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1177\/1538574412469446","article-title":"Seat belt injuries of the abdominal aorta in adults--case report and literature review.","volume":"47","author":"Freni","year":"2013","journal-title":"Vasc Endovascular Surg"},{"key":"R4-20261109","doi-asserted-by":"crossref","first-page":"3471","DOI":"10.1177\/00031348231174009","article-title":"Identifying radiographic and clinical indicators to reduce the occurrence of nontherapeutic laparotomy for blunt bowel and mesenteric injury.","volume":"89","author":"Blackley","year":"2023","journal-title":"Am Surg"},{"key":"R5-20261109","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1177\/0846537120908132","article-title":"Evaluation of bowel and mesentery in abdominal trauma.","volume":"71","author":"Durrant","year":"2020","journal-title":"Can Assoc Radiol J"},{"key":"R6-20261109","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40792-019-0767-6","article-title":"Laceration of the transverse mesocolon in an old man with a habit of abdominal massage for constipation: a case report.","volume":"6","author":"Mori","year":"2020","journal-title":"Surg Case Rep"},{"key":"R7-20261109","doi-asserted-by":"crossref","first-page":"101104","DOI":"10.1016\/j.tcr.2024.101104","article-title":"An isolated mesenteric hematoma following blunt abdominal trauma - case report and literature review.","volume":"54","author":"Yonemitsu","year":"2024","journal-title":"Trauma Case Rep"},{"key":"R8-20261109","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/S0020-1383(75)80012-X","article-title":"Isolated mesenteric injury due to blunt abdominal trauma.","volume":"7","author":"McCullough","year":"1976","journal-title":"Injury"},{"key":"R9-20261109","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1016\/j.amsu.2015.09.010","article-title":"Mechanical small bowel obstruction following a blunt abdominal trauma: a case report.","volume":"4","author":"Zirak-Schmidt","year":"2015","journal-title":"Ann Med Surg (Lond)"},{"key":"R10-20261109","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1097\/TA.0000000000000924","article-title":"A case of small bowel obstruction after large mesenteric hematoma in blunt abdominal trauma.","volume":"80","author":"Jung","year":"2016","journal-title":"J Trauma Acute Care Surg"},{"key":"R11-20261109","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.asjsur.2013.01.006","article-title":"Delayed small bowel perforation following blunt abdominal trauma: a case report and review of the literature.","volume":"39","author":"Hamidian Jahromi","year":"2016","journal-title":"Asian J Surg"},{"key":"R12-20261109","doi-asserted-by":"crossref","first-page":"271","DOI":"10.12659\/PJR.900382","article-title":"Delayed small bowel perforation with findings of severe ischemia following blunt abdominal trauma.","volume":"82","author":"Evrimler","year":"2017","journal-title":"Pol J Radiol"},{"key":"R13-20261109","first-page":"620","article-title":"Case report: delayed presentation of bowel obstruction caused by blunt abdominal trauma.","volume":"4","author":"George","year":"2020","journal-title":"Clin Pract Cases Emerg Med"},{"key":"R14-20261109","doi-asserted-by":"crossref","first-page":"106930","DOI":"10.1016\/j.ijscr.2022.106930","article-title":"Successful conservative management of a large traumatic mesenteric hematoma: a case report.","volume":"93","author":"Basukala","year":"2022","journal-title":"Int J Surg Case Rep"},{"key":"R15-20261109","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.injury.2017.09.004","article-title":"Avoiding delayed diagnosis of significant blunt bowel and mesenteric injuries: Can a scoring tool make the difference? A 7-year retrospective cohort study.","volume":"49","author":"Zingg","year":"2018","journal-title":"Injury"},{"key":"R16-20261109","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s13017-022-00418-y","article-title":"WSES guidelines on blunt and penetrating bowel injury: diagnosis, investigations, and treatment.","volume":"17","author":"Smyth","year":"2022","journal-title":"World J Emerg Surg"}],"container-title":["Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/MD.0000000000041920","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T18:01:19Z","timestamp":1794247279000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/MD.0000000000041920"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,21]]},"references-count":16,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.1097\/md.0000000000041920","relation":{},"ISSN":["1536-5964","0025-7974"],"issn-type":[{"value":"1536-5964","type":"electronic"},{"value":"0025-7974","type":"print"}],"subject":[],"published":{"date-parts":[[2025,3,21]]}}}