Use of the omentum in the management of mesenteric contusions: a case report and review of the literature

Abstract

Closed abdominal trauma can result in severe mesenteric injury, potentially progressing to intestinal necrosis requiring resection. We report the case of a 24-year-old female patient, victim of a road traffic accident, with two mesenteric contusions: one responsible for intestinal necrosis requiring a double stoma, and the other located upstream, with preservation of a feeding vessel. An innovative technique was used to preserve this vascularization: a pedicled omental flap, still attached to the omental apron, was mobilized to cover and stabilize the mesenteric vessel. The omentum was fixed using resorbable sutures to ensure stabilization without compromising vascularization. The proximal location of the affected intestinal segment allowed for tension-free omental transposition. The post-operative outcome was favorable, with continuity restored two months later. This case highlights the importance of the role of the omentum in digestive reconstruction and vascular preservation, and proposes a reflection on its integration into standardized surgical protocols.