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Íleo mecánico y gangrena gaseosa secundarios a fractura pélvica
Mechanical ileus and gas gangrene due to pelvic fracture
Visitas
...
R. Martínez Pardavilaa, AM. Martínez Matab, A. Arévalo Manriquea, F. Sáez Aldanac, J. Ochoa Gómezd, B. Escudero Naldaa, J. Cabello del Castilloa
a Servicio de Cirug??a General y del Aparato Digestivo (Dr. J. Cabello del Castillo). Complejo Hospitalario San Mill??n-San Pedro. Logro??o.
b Radiodiagn??stico. Complejo Hospitalario San Mill??n-San Pedro. Logro??o.
c Traumatolog??a. Complejo Hospitalario San Mill??n-San Pedro. Logro??o.
d Cuidados Intensivos. Complejo Hospitalario San Mill??n-San Pedro. Logro??o.
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Mechanical ileus secondary to pelvic fracture is very difficult to diagnose due to its low frequency, when compared with adynamic ileus. This complication, often overlooked, should be taken into consideration because a late or incorrect diagnosis is associated with poorer prognosis.

We present a case of gas gangrene secondary to small bowel entrapment and perforation caused by a pelvic fracture, and review the literature.

We found 12 patients, ranging in age from 13 to 80 years. Mechanical ileus was most frequently associated with acetabular fracture and small bowel involvement. It was diagnosed between 2 and 21 days after the pelvic fracture. Most of the patients were treated by resection of the affected bowel segment, end-to-end anastomosis, fracture gap debridement and reperitonization. The rate of mortality was 41%.

The diagnosis of mechanical ileus secondary to pelvic fracture is difficult and nearly always late, resulting in a worse prognosis. In the presence of signs and symptoms such as pelvic fracture with bowel obstruction, hypotension unrelated to hypovolemia, tachycardia and poor general condition, computed tomography will usually lead to the correct diagnosis.

Keywords:
Gas gangrene
Mechanical ileus
Bowel entrapment
Pelvic fracture

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