An indolent case of traumatic bowel injury as a superior mesenteric artery syndrome mimic

Traumatic bowel injury is an uncommon injury pattern that can have a delayed presentation after an initial trauma hospitalization and present to pediatricians with nonspecific symptoms. This syndrome is often missed and can mimic other common gastrointestinal conditions. Our case presents a previously healthy 16-year-old girl with recent trauma admission who re-presented to the hospital with a presumed superior mesenteric artery syndrome and had a mixed response to initial management. Given persistent symptoms despite standard care, subsequent management consisted of an exploratory laparotomy that led to findings of a strictured segment of the bowel that was resected and led to clinical recovery. These patients can initially present with normal imaging and have an evolving inflammatory-mediated process due to microvascular injury and abscess formation. These injuries should be included in the differential diagnosis of patients with nausea, vomiting, abdominal pain, weight loss, and fever in the setting of recent blunt abdominal trauma.