Journal of Trauma and Injury

Case Reports

An unusual open pneumothorax due to high-voltage electrical burn injury: a case report: Norberto Navarrete, Sandra J. Bernal, Laura S. Nasiff, Federico Fernandez; Received May 29, 2025 Accepted August 11, 2025 Published online April 1, 2026; DOI: https://doi.org/10.20408/jti.2025.0122 [Epub ahead of print]

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Abstract PDF: Open intrathoracic visceral injuries are rare in electrical burns. We report the case of a 65-year-old man who sustained a high-voltage electrical burn through direct cable exposure. He arrived at the burn intensive care unit with respiratory distress secondary to an open wound on the right side of the chest wall measuring approximately 4×2 cm, with a calculated total body surface area of 2%. An immediate thoracostomy tube was placed to treat the open pneumothorax. Pneumopericardium, pneumomediastinum, and pleural infection developed later as delayed complications despite initial stabilization. After 42 days of hospitalization, the patient was discharged. This case highlights the rare occurrence of thoracic complications following electrical injury and underscores the importance of multidisciplinary, phased therapy in the management of severe electrical damage.; Summary

Complete avulsion of the proximal hamstring tendon in a young gymnast: a case report: Shreya Jaiwant Gudigar, Pavan Kumar A, P. K. Karthik Yelamarthy, S. T. Ramanuja Chari, Raghava Dutt Mulukutla, Preeti Shah; Received May 27, 2025 Accepted August 19, 2025 Published online April 1, 2026; DOI: https://doi.org/10.20408/jti.2025.0121 [Epub ahead of print]

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Abstract PDF: Proximal hamstring complex tears are uncommon injuries in gymnastics. This case report describes a rare instance of a 17-year-old female gymnast who sustained a complete avulsion of the proximal hamstring complex during exercise. The injury was diagnosed clinically and later confirmed by magnetic resonance imaging as a proximal hamstring tear, prompting surgical repair with suture anchors. The patient underwent a structured rehabilitation program with progressive milestones in weight-bearing, mobility, and strength training. By postoperative 26 weeks, she had regained functional strength and returned to competitive activity. This case highlights the importance of early diagnosis, timely surgical intervention, and a carefully managed rehabilitation protocol in achieving successful outcomes for young gymnasts. It also underscores the need for greater awareness and documentation of proximal hamstring complex tears in gymnastics, where such cases remain underreported. This report demonstrates the potential for full recovery and return to sport with appropriate treatment and rehabilitation, providing valuable insight into the management of this rare injury.; Summary

Blunt traumatic right-sided pericardial rupture without cardiac injury: a case report: Muhyung Heo, Hyung Won Kim, Sanghyun Sung; Received May 21, 2025 Accepted July 30, 2025 Published online April 1, 2026; DOI: https://doi.org/10.20408/jti.2025.0112 [Epub ahead of print]

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Abstract PDF: Blunt traumatic pericardial rupture is an exceptionally rare condition, often associated with high morbidity and mortality. Isolated pericardial rupture without vascular or cardiac involvement accounts for only 17% of reported cases. We describe a rare case of right-sided pericardial rupture following blunt chest trauma, an unusual presentation since most pericardial tears occur on the left side. A 23-year-old woman involved in a motor vehicle accident sustained multiple injuries, including right hemothorax, bilateral pulmonary contusions, left-sided rib fractures, and a humerus fracture. Although preoperative computed tomography showed no diagnostic findings, persistent bleeding from the right chest tube prompted exploratory thoracotomy. Intraoperative evaluation revealed a 10-cm right pericardial tear extending from the superior vena cava to the inferior vena cava, with no associated cardiac injury. Surgical management included primary closure of the pericardial tear and repair of adjacent pleural injuries. Postoperatively, the patient developed right diaphragmatic palsy due to phrenic nerve involvement. Pericardial rupture is challenging to diagnose, but in this case, persistent hemothorax facilitated early recognition and intervention. Prompt identification allowed timely surgical repair, likely preventing life-threatening complications such as cardiac herniation. This case highlights the importance of considering pericardial rupture in patients with blunt chest trauma presenting with unexplained clinical findings and underscores the value of early surgical management.; Summary

Original Article

Patterns of penetrating trauma in New York City before, during, and after the COVID-19 pandemic: Elias Youssef, Bonny J. Baron, Andrew Sweeny, Hossein Kalantari, Roshanak Benabbas, Valery Roudnitsky, Donald Doukas, Hope A. Taitt, Nathanaens O. Estervil, Shahriar Zehtabchi; J Trauma Inj. 2026;39(1):52-59. Published online March 31, 2026; DOI: https://doi.org/10.20408/jti.2025.0196

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Abstract PDF: Purpose
The COVID-19 pandemic profoundly impacted multiple sectors of society, including healthcare. Major cities such as New York City (NYC) saw shifts in injury numbers and patterns during this period, underscoring the need to track these fluctuations to optimize resource allocation, improve trauma protocols, and inform public health policy. We examined trends in penetrating trauma in NYC before, during, and after the COVID-19 pandemic.
Methods
This retrospective cohort study used data from the NYC Health + Hospitals, which includes 11 acute care hospitals and trauma centers citywide. We analyzed electronic medical records from five level I trauma centers and one level II trauma center (pediatric level I) from August 1, 2019, to November 30, 2024. The study included patients with penetrating injuries and excluded minor-mechanism penetrating injuries or those incompatible with stab or gunshot mechanisms. Patients presenting for follow-up of prior injuries were excluded. The study timeframe was divided into three periods: pre–COVID-19 (August 1, 2019–February 29, 2020), COVID-19 (March 1, 2020–December 31, 2021), and post–COVID-19 (January 1, 2022–November 30, 2024). Descriptive statistics were used to summarize demographic and injury characteristics. Proportions are reported as percentages and continuous variables as medians with interquartile ranges (IQRs).
Results
Data for 9,118 patients were analyzed. Most were male (87.5%), with a median age of 30 years (IQR, 23–39 years). The incidence of penetrating trauma increased significantly during the COVID-19 period (164 cases per month) compared with pre–COVID-19 (110 cases per month) and post–COVID-19 (136 cases per month). Stab wounds were the most common injury type across all periods (53.7%).
Conclusions
Penetrating trauma cases increased notably during the COVID-19 pandemic in NYC, consistent with nationwide trends. Although not directly measured, socioeconomic stressors such as economic instability, social isolation, and substance abuse are plausible contributors to this increase.; Summary

Case Reports

The voice of injury: a case report of isolated trauma to the larynx: Najeebuddin Mohammed, Ashima Sharma, Alekhya Machani, Sujata Patnaik; J Trauma Inj. 2026;39(1):85-89. Published online March 31, 2026; DOI: https://doi.org/10.20408/jti.2025.0065

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Abstract PDF: Although uncommon, laryngotracheal injuries carry a significant risk of mortality. This rare case of isolated laryngeal injury underscores the importance of recognizing the various potential presentations of such injuries and highlights the evidence-based management strategies that every emergency physician should consider when treating potential airway trauma. A 45-year-old male motorcyclist was involved in a road traffic accident during the night and presented to the emergency department the following morning. The patient complained of breathlessness, neck pain, hoarseness of voice, and noisy breathing. Examination revealed stridor, swelling in zones 1 and 2 of the neck, tenderness over the thyroid, and subcutaneous emphysema over the neck and anterior chest. A definitive airway was secured, and computed tomography imaging revealed a fracture of the thyroid cartilage. The patient was managed conservatively, extubated after 1 week, and discharged after 2 days of observation. Classification of the type of injury and the use of an algorithmic approach, involving consensus among the emergency department, trauma surgeons, and the critical care team, can help streamline and standardize management of these cases. Furthermore, a thorough understanding of the dos and don’ts in securing the airway in patients with laryngotracheal injuries increases the robustness of the approach to managing this patient population.; Summary

Pneumatosis cystoides intestinalis misdiagnosed as pneumoperitoneum due to colon perforation in a patient with blunt trauma injuries: a case report: So Ra Ahn, Joo Hyun Lee, Chan Yong Park; Received July 14, 2025 Accepted August 31, 2025 Published online March 30, 2026; DOI: https://doi.org/10.20408/jti.2025.0155 [Epub ahead of print]

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Abstract PDF: A laparotomy is usually performed when pneumoperitoneum is identified on abdominal computed tomography (CT) in patients with trauma-related injuries. However, in rare cases, pneumatosis cystoides intestinalis (PCI) may be misinterpreted as free air due to bowel perforation. PCI typically follows a benign course and can be managed with physical examinations and imaging studies. In this case, however, the patient was comatose from a severe traumatic brain injury, rendering the physical examination unreliable. Abdominal CT revealed multiple extraluminal air foci in the retroperitoneal space surrounding the ascending colon, consistent with pneumoperitoneum. No evidence of intraoperative peritonitis was found. Nevertheless, because bowel perforation could not be definitively excluded, a right hemicolectomy was performed, and histopathological examination confirmed PCI.; Summary

Facial trauma and reconstructive surgery: insights from a case series of severe maxillofacial injuries: Harendra Kumar, Abdul Hakeem, Abdul Vakil Khan, Rachith Sridhar, Deepak Kumar, Majid Anwer; J Trauma Inj. 2026;39(1):94-103. Published online February 4, 2026; DOI: https://doi.org/10.20408/jti.2025.0080

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Abstract PDF: Facial trauma is a complex and important contributor to trauma-related morbidity, often requiring multidisciplinary management due to intricate anatomy and the dual need for functional and aesthetic restoration. This case series describes a spectrum of maxillofacial injuries treated by trauma surgeons, including soft tissue degloving, zygomaticomaxillary complex fractures, mandibular fractures, and airway compromise. All patients were managed in accordance with Advanced Trauma Life Support (ATLS) principles. Surgical interventions included layered wound closure, open reduction and internal fixation, and airway management through endotracheal intubation, cricothyroidotomy, or tracheostomy. The series underscores the critical decision-making required in airway management, the surgical expertise necessary for fracture stabilization, and the importance of early reconstruction in optimizing outcomes. It further emphasizes the role of trauma surgeons in delivering comprehensive care and highlights the value of preventive strategies such as helmet use and road safety enforcement. These cases contribute to the growing evidence that timely, coordinated surgical intervention supports optimal recovery in patients with facial trauma.; Summary

Original Articles

Vascularized tissue coverage of trauma and acute care surgery defects with ovine forestomach matrix: interim results of a prospective multicenter study: Michael T. Cormican, W. Matthew Vassy, Carolyn Cook, Christopher A. Butts, John Loftus, Jessica Simon, D. Adam Young, Alison A. Smith; J Trauma Inj. 2026;39(1):42-51. Published online January 20, 2026; DOI: https://doi.org/10.20408/jti.2025.0090

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Abstract PDF Supplementary Material

Purpose
Traumatic soft tissue defects present challenges due to their diverse presentations. This variability necessitates tailored approaches for effective management, requiring advanced reconstruction strategies to achieve rapid coverage and tissue infill while minimizing complications. The study aimed to evaluate the safety of ovine forestomach matrix (OFM) grafts in traumatic defects from four level I trauma centers.
Methods
This prospective observational study used a multicenter registry to collect deidentified data from adult trauma/acute care surgery patients who received OFM-based grafts for soft tissue repair from August 2022 through September 2024. After the application of OFM grafts, defects were regularly assessed for the development of vascularized tissue coverage and/or fill, and ultimately epithelialization.
Results
During the study, 49 participants with 61 soft tissue defects underwent procedures with OFM-based grafts. The mean participant age was 58.8±17.7 years. Most defects (55.7%) resulted from traumatic injuries, with additional etiologies including necrotizing soft tissue infections (13.1%), enterocutaneous fistulas (4.9%), acute pressure injuries (stages III and IV, 6.6%), surgical dehiscence (4.9%), amputations (3.3%), and hematoma evacuation (3.3%). All defects achieved vascularized tissue coverage within a median of 22.5 days (interquartile range, 13.3–33.5 days) after a median of one product application (interquartile range, 1–1). Four cases of superficial infection were reported, all resolving without major complications.
Conclusions
OFM-based grafts showed promising results in tissue regeneration for trauma and acute care defects, with minimal postoperative complications. These results are interim findings from an ongoing prospective multicenter registry study evaluating the safety and efficacy of OFM-based grafts in various surgical applications.

Summary

Citations

Citations to this article as recorded by

Reconstruction of Deep Partial-Thickness Burns With Ovine Forestomach Matrix: Results From a Prospective Observational Study
Patrick J Kennedy, Michael Young, Kylie Wentworth, Nidhi Aravapalli, Nicole P Bernal, Ariel Rodgers, Laura Pezzopane, Beth McGuire, Jessica Simon, D. Adam Young, John Loftus
Cureus.2026;[Epub] CrossRef
Ovine forestomach matrix for wound treatment: an integrative review
Marcos Fortes, João Moreira, Ana Carolina Fernandes, Débora Wilbert
European Journal of Plastic Surgery.2026;[Epub] CrossRef

Venous phase extravasation on computed tomography is a red flag sign in critical/severe pelvic injuries: Hong Kyung Shin, Chami Im, Hye Rim Shin, Mi Jeong Choi, Jung-Woo Woo; J Trauma Inj. 2025;38(4):360-365. Published online December 31, 2025; DOI: https://doi.org/10.20408/jti.2025.0198

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Abstract PDF: Purpose
Managing hemodynamically unstable patients with pelvic fractures is highly challenging, particularly when vascular injuries are present, as these can significantly worsen prognosis. This study evaluated outcomes in patients with pelvic trauma and vascular injuries prior to the introduction of preperitoneal pelvic packing.
Methods
We retrospectively reviewed the medical records of 195 patients with pelvic injuries who presented to the emergency room of our hospital between May 2003 and August 2013.
Results
Among the 195 patients, 34 had vascular injuries and 161 had nonvascular injuries. The vascular injury group had significantly higher transfusion rates (82.4% vs. 11.8%, P<0.001) and required a greater mean number of packed red blood cell units than the nonvascular group (5.2±5.5 vs. 0.4±1.4, P<0.001). Subgroup analysis within the vascular injury cohort revealed significant differences between patients with venous phase extravasation (n=5) and those with isolated arterial phase extravasation (n=29) in median packed red blood cell units transfused (12.5 units vs. 3 units; P=0.014), cardiac arrest rate (80.0% vs. 10.3%, P=0.003), and mortality rate (60.0% vs. 10.3%, P=0.029). Notably, patients with isolated venous extravasation showed a significantly higher mortality rate compared to those with isolated arterial extravasation (100% vs. 10.3%, P=0.004).
Conclusions
Venous phase extravasation was associated with higher transfusion requirements, cardiac arrest incidence, and mortality compared to arterial extravasation.; Summary

Case Report

Catastrophic complications from inadequate early soft tissue surveillance in a closed pilon fracture: a case report: Jeong-Hyun Koh, Sumin Lim, Hyung Keun Song, Wan-Sun Choi, Won-Tae Cho, Seungyeob Sakong; J Trauma Inj. 2025;38(4):404-411. Published online December 31, 2025; DOI: https://doi.org/10.20408/jti.2025.0158

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Abstract PDF: We present the case of a 55-year-old man with an AO/OTA 43-C3 pilon fracture in whom initial uniplanar external fixation failed to relieve persistent medial skin tenting, resulting in focal ischemic necrosis. Within 72 hours, the patient developed bullae and violaceous discoloration, which progressed to full-thickness skin breakdown. Despite staged open reduction and internal fixation and fasciocutaneous flap coverage, the patient developed chronic osteomyelitis, ultimately requiring segmental bone resection to control the infection. The patient underwent serial debridement procedures and placement of antibiotic-loaded cement spacers. Definitive reconstruction was achieved with salvage tibiotalocalcaneal arthrodesis using the Expert Tibial Nail system on postoperative day 319. Twelve months after fusion and bone grafting, radiographs confirmed solid union, and the patient was ambulating independently, albeit with considerable long-term functional limitations. This case underscores the importance of early and meticulous soft tissue evaluation in high-energy pilon fractures. Prompt repositioning of fracture fragments or the use of adjunctive decompression is essential. Delayed or inadequate decompression can lead to a cascade of complications, beginning with soft tissue necrosis and progressing to deep infection and limb salvage fusion, even when standard fixation protocols are followed.; Summary

Original Article

Comparing the Full Outline of Unresponsiveness (FOUR) score and the Glasgow Coma Scale (GCS) for predicting outcomes in traumatic brain injury: a comparative study: Harsh Jain, Jishnu N. Nair, Davuluri Venkata Shashank, Visvanathan Krishnaswamy, Krishnamurthy Ganesh; J Trauma Inj. 2025;38(4):327-334. Published online December 31, 2025; DOI: https://doi.org/10.20408/jti.2025.0125

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Abstract PDF: Purpose
Traumatic brain injuries (TBIs) are a leading cause of morbidity, mortality, socioeconomic loss, and diminished quality of life among survivors of all injury types. The Glasgow Coma Scale (GCS), though commonly used in the intensive care unit (ICU), has limitations that may be addressed by the Full Outline of Unresponsiveness (FOUR) score. We compared the ability of the FOUR and GCS scores to predict outcomes in patients with TBI.
Methods
This prospective observational study included all patients presenting with head injury who survived beyond 24 hours between 2020 and 2022. Basic demographic data, prehospital care details, and neurological findings were collected. TBI severity was assessed using both the GCS and FOUR scores, and outcomes were graded using the Glasgow Outcome Score (GOS).
Results
Among 225 patients (mean age, 42.4±19.7 years; male sex, 77.8%) with TBIs, the mortality rate was 4.4%, and 15.1% experienced a poor outcome (GOS ≤2). Receiver operating characteristic curve analysis showed good predictive ability for both the FOUR score (area under the curve [AUC], 0.85) and GCS (AUC, 0.88). FOUR score ≤12 and GCS ≤10 were identified as optimal cutoff values for predicting poor outcomes (P<0.001), with the FOUR score demonstrating sensitivity and specificity of 79.4% and 77.5%, respectively. A FOUR score ≤12 at admission was significantly associated with intubation (odds ratio [OR], 8.2; 95% confidence interval [CI], 4.6–14.4; P<0.001), tracheostomy (OR, 21.8; 95% CI. 6.9–68.8; P<0.001), and neurological complications, including mental function deficits (OR, 7.5; 95% CI, 3.2–17.7; P<0.001), cranial nerve palsy (OR, 4.1; 95% CI, 1.6–10.4; P=0.002), and motor deficits (OR, 9.4; 95% CI, 4.6–19.2; P<0.001). A strong correlation was observed between the FOUR score and GOS (r=0.7).
Conclusions
The FOUR score is a reliable tool for assessing TBI severity and predicting outcomes, with performance comparable to the GCS. An admission FOUR score ≤12 was associated with poor neurological outcomes, increased need for advanced airway management, and long-term disability. By capturing additional neurological parameters beyond the GCS, the FOUR score may offer clinical advantages in ICU settings for early prognostication and management of patients with TBI.; Summary

Case Report

Foreign body retained in the sole of the foot for over 30 years: a case report: Min Gyu Kyung; J Trauma Inj. 2026;39(1):90-93. Published online December 29, 2025; DOI: https://doi.org/10.20408/jti.2025.0107

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Abstract PDF: A 41-year-old man presented with discomfort in the medial arch of his foot, which worsened with weight-bearing. The condition had initially been misdiagnosed as plantar fasciitis, and he had received conservative treatment without imaging, with no relief of symptoms. Plain radiography and computed tomography later revealed a 2.5-cm radiopaque, needle-like foreign body in the superficial midfoot. Further history-taking revealed that the patient had stepped on a sewing needle during childhood, approximately 35 years earlier. The foreign body was surgically removed through an extended incision, as it was encased in granulomatous tissue and was not easily accessible via a minimally invasive approach. Histopathological examination confirmed a fibrous reaction with granuloma formation surrounding the retained metallic object. The patient remained asymptomatic postoperatively and returned to normal activity. To the author’s knowledge, this is the first reported case of a sewing needle retained in the foot for over 30 years without an allergic reaction or infection. Although many foreign bodies are detected shortly after injury, this case highlights the importance of thorough history-taking and appropriate imaging, especially when symptoms mimic common conditions such as plantar fasciitis. Additionally, in long-standing cases, complete encapsulation by reactive tissue may necessitate more extensive surgical exposure for successful removal.; Summary

Original Article

Use of the Obstetric Early Warning Score in emergency triage for pregnant trauma patients: a retrospective cross-sectional study on a tool for early hospitalization decision-making: Figen Topalak, Selen Acehan, Salim Satar, Muge Gulen, Sarper Sevdimbas, Kadir Nigiz, Mehmet Gorur, Ali İsa Aslan, Ihsan Dengiz; J Trauma Inj. 2026;39(1):25-33. Published online December 29, 2025; DOI: https://doi.org/10.20408/jti.2025.0104

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Abstract PDF: Purpose
Traumatic injuries during pregnancy present significant challenges for emergency providers, necessitating rapid assessment to ensure the safety of both mother and fetus. Scoring systems that can be applied immediately upon presentation may facilitate early triage and inform disposition decisions. This study evaluated the predictive performance of the Obstetric Early Warning Score (OEWS), Injury Severity Score (ISS), and Revised Trauma Score (RTS) in determining hospitalization needs among pregnant trauma patients admitted to the emergency department (ED).
Methods
This retrospective cross-sectional study included pregnant trauma patients aged 18 years or older who were admitted to a tertiary care ED between January 2019 and December 2022. Demographic, clinical, laboratory, and trauma-related data were collected. OEWS, ISS, and RTS were calculated at admission. The primary outcome was the requirement for hospitalization. Binary logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess predictive performance.
Results
A total of 316 pregnant trauma patients were included. Hospitalization was required in 14.9% of cases. Higher OEWS (mean, 2.63 vs. 0.33; P=0.001) and ISS (mean, 18.02 vs. 5.04; P<0.001) were significantly associated with hospitalization. In multivariate analysis, OEWS (odds ratio [OR], 1.553; 95% confidence interval [CI], 1.087–2.219; P=0.016) and ISS (OR, 1.170; 95% CI, 1.083–1.264; P<0.001) were independent predictors of hospitalization. ROC analysis demonstrated that ISS had the highest predictive value (area under the curve, 0.783; 95% CI, 0.695–0.870; P<0.001).
Conclusions
Both ISS and OEWS are effective tools for predicting hospitalization needs in pregnant trauma patients. Incorporating these scoring systems into ED triage protocols may enhance early identification of high-risk patients and improve outcomes for both mothers and fetuses.; Summary

Review Article

Prognostic role of serum interleukin-6 levels in polytrauma patients: a comprehensive narrative review: Nicola Madani, Sereen Halayqeh, Hebah Almahariq, Ahmad Al-Badawi, Mohammad Alomari, Bassem Haddad; J Trauma Inj. 2026;39(1):4-13. Published online December 29, 2025; DOI: https://doi.org/10.20408/jti.2025.0081

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Abstract PDF

Polytrauma triggers a complex systemic inflammatory response, and early identification of high-risk patients is essential for guiding timely interventions and improving outcomes. Interleukin-6 (IL-6), a rapidly induced proinflammatory cytokine, has emerged as a potential biomarker for prognosis in the trauma setting. This narrative review summarizes current evidence on the prognostic role of IL-6 in polytrauma patients, addressing its biological functions, kinetics after injury, and associations with clinical outcomes such as acute respiratory distress syndrome, multiple organ dysfunction syndrome, intensive care unit admission, and mortality. IL-6 levels have been shown to correlate with injury severity scores and to predict complications more reliably than many other inflammatory markers, largely due to its early elevation and sustained presence in circulation. Furthermore, IL-6 measurement may inform surgical decision-making, particularly in selecting candidates for damage control strategies versus definitive care. Compared to other cytokines and acute-phase reactants, IL-6 demonstrates superior temporal responsiveness and prognostic accuracy in the early postinjury phase. Despite variability in measurement methods and the influence of external confounding factors, IL-6 holds significant promise as a clinical tool for early triage, risk stratification, and potentially therapeutic targeting in trauma care. Standardized protocols and larger multicenter studies are needed to facilitate broader adoption and integration of IL-6 into clinical algorithms.

Summary

Citations

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The Importance of the “Damage Control” Strategy in Multiple Organ Injuries, Pathophysiology and Principles of Hemorrhage Control
Oliwia Klimek, Jakub Dudek, Anna Czesyk, Bartosz Sierant, Wiktoria Górecka, Grzegorz Gogolewski, Tomasz Jurek, Zuzanna Ochocka, Amelia Jankowska
Journal of Clinical Medicine.2026; 15(7): 2549. CrossRef

Case Report

Bowel maneuvers for achieving colonic continuity after extensive colon resection due to abdominopelvic trauma: two case reports: Barak Raguan, Fahim Awaad, Ephraim Katz, Dean Lutrin, Yoram Klein, Ilan Kent; Received March 6, 2025 Accepted May 15, 2025 Published online November 20, 2025; DOI: https://doi.org/10.20408/jti.2025.0052 [Epub ahead of print]

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Abstract PDF: Restoring large bowel continuity after extensive resection due to abdominopelvic trauma may be challenging because of the limited length of the remaining bowel. Achieving a tension-free anastomosis can be particularly difficult when attempting this within the pelvis due to a short rectal stump. Two maneuvers that can aid in these situations are the retroileal pull-through approach and the Deloyers procedure. We describe two cases in which each maneuver was utilized to facilitate colostomy closure following extensive large bowel resection resulting from abdominopelvic trauma. Both maneuvers proved feasible, successfully allowing bowel continuity to be restored with tension-free anastomoses. Protective loop ileostomies were performed in both cases. Postoperative contrast enema studies did not show evidence of anastomotic leaks. After ileostomy closure, both patients regained bowel function with good bowel control. Bowel manipulation maneuvers following abdominal trauma are therefore feasible and facilitate tension-free anastomosis after extensive colonic and rectal resections. Trauma and colorectal surgeons managing abdominal trauma patients requiring ostomy closure should become familiar with these techniques.; Summary

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