Multidisciplinary Management of Complex Vascular and Bowel Injuries in a Hemodynamically Unstable Trauma Patient

Smith S*, Moore G and Mabes ES

Medical College of Georgia at Augusta University, USA

^*Correspondance to: Samantha Smith 

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Abstract:

A 31-year-old man presented to a Level I trauma center with two penetrating ballistic wounds to the left upper quadrant and right posterior thigh. The patient was taken to the operating room for an exploratory laparotomy, and upon entry to the abdomen, hemoperitoneum was encountered by the surgical team. Examination of the small bowel revealed four enterotomies, which were resected and repaired with stapled side-to-side anastomoses. An expanding hematoma in the right anterior pelvis and thigh was identified, with further exploration yielding significant defects of the femoral artery and femoral vein with active hemorrhage. Vascular surgery was urgently consulted and performed an end-to-end anastomosis of the femoral artery with a reverse great saphenous vein interposition graft and a patch angioplasty of the femoral vein using Bovine pericardium. Angiogram confirmed anterograde flow to the distal lower extremity, after which a four-compartment fasciotomy was performed. A blast injury to the transverse colon was resected and left in discontinuity due to the patient’s hemodynamic instability. This case demonstrates the utility of multidisciplinary collaboration in the trauma setting for definitive repair of vascular and bowel injuries. Prompt consultation allowed for simultaneous trauma and vascular surgical procedures to be performed, resulting in rapid, life-saving treatment.

Keywords:

Bowel Injuries; Angiogram; Hemorrhage

Cite the Article:

Smith S, Moore G, Mabes ES. Multidisciplinary Management of Complex Vascular and Bowel Injuries in a Hemodynamically Unstable Trauma Patient. Clin Case Rep Int. 2026; 10: 1764..