Subadventitial rupture of the splanchnic arteries as the result of blunt abdominal trauma presenting with acute gastric dilatation.

Two patients are reported who presented with intestinal ischaemia caused by a subadventitial rupture of the origin of the coeliac trunk and superior and inferior mesenteric arteries after blunt trauma from deceleration injury. In both cases the initial clinical examination revealed a painful abdomen without any 'peritonism'. Abdominal ultrasonographic examination showed no abnormality. Plain abdominal radiography showed gastric dilatation in both patients. In the first, the diagnosis was made by laparatomy but only after 2 days. In the second, diagnosis was made by aortography performed because of the early appearance of gastric dilatation. Both patients died as a result of extensive associated injuries and delay in diagnosis.