Colonic injury during delayed surgical stabilization of rib fractures for flail chest: A case report and literature review

Abstract

Surgical stabilization of rib fractures (SSRFs) is becoming increasingly common, particularly in the setting of flail chest. In adult patients with flail chest, SSRF has been shown to reduce mortality, the incidence of pneumonia, and the need for tracheostomy, in addition to shortening the duration of mechanical ventilation, hospital length of stay (LOS), and intensive care unit LOS. Despite rising popularity, SSRF is not without risks. We present the case of a 22-year-old man who sustained an iatrogenic colonic injury during delayed SSRF for severe nonunion and chest wall motion abnormalities after a motorcycle collision. In multisystem injured trauma patients, it is important to remain cognizant of possible anatomic alterations that could affect surgical management. We present a very uncommon, yet devastating complication related to anatomic alterations from the initial injury.