SMALL BOWEL CONTUSION AND PERFORATION DUE TO UNCOMMON BLUNT ABDOMINAL TRAUMA

Hana Nikšić; Dragan Vasin; Boris Tadić; Miloš Raspopović; Zlatko Perišić; Mirjana Božić; Sanela Hasanagić; Dragan Mašulović

doi:10.5937/sanamed0-47955

Hana Nikšić University Clinical Center of Serbia, Center of Radiology and Magnetic Resonance, Belgrade, Serbia
Dragan Vasin ¹University Clinical Center of Serbia, Center of Radiology and Magnetic Resonance, Belgrade, Serbia; 2. University of Belgrade, Faculty of Medicine, Belgrade, Serbia
Boris Tadić 1. University of Belgrade, Faculty of Medicine, Belgrade, Serbia ; 2. University Clinical Center of Serbia, Clinic for Emergency Surgery, Serbia
Miloš Raspopović 1. University of Belgrade, Faculty of Medicine, Belgrade, Serbia; 2. University Clinical Center of Serbia, Clinic for Emergency Surgery, Serbia
Zlatko Perišić 1. University of Belgrade, Faculty of Medicine, Belgrade, Serbia; 2. University Clinical Center of Serbia, Clinic for Emergency Surgery, Serbia
Mirjana Božić University of Belgrade, Faculty of Medicine, Belgrade, Serbia
Sanela Hasanagić University of Belgrade, Faculty of Medicine, Belgrade, Serbia
Dragan Mašulović University of Belgrade, Faculty of Medicine, Belgrade, Serbia

DOI: https://doi.org/10.5937/sanamed0-47955

Keywords: Blunt abdominal trauma, Jejunal perforation, Contusion, Computed tomography, Surgery

Abstract

Introduction: Small bowel injuries are rare, accounting for only 1% - 5% of injuries following blunt abdominal trauma, while small bowel perforation has been reported in 0.3% of patients. Delays in early diagnosis or misdiagnosis significantly contribute to the mortality and morbidity associated with small bowel injuries. Blunt abdominal trauma poses a diagnostic challenge, with focused assessment using sonography in trauma and computed tomography abdomen becoming invaluable methods for diagnosis, integrated into management guidelines.

Case Report: We present a case of jejunal perforation and contusion resulting from blunt abdominal injury due to a fall onto a fence. The initial chest X-ray did not reveal any traumatic injuries or subdiaphragmatic free gas. Computed tomography of the abdomen and small pelvis revealed free fluid in the peritoneal cavity and thickening of the jejunal wall, corroborated by abdominal ultrasound. Surgical intervention confirmed a diagnosis of small jejunal perforation.

Conclusion: Given the minimal and often clinically undetectable signs in patients with blunt abdominal trauma, timely and accurate imaging diagnostics and prompt surgical intervention significantly reduce the morbidity and mortality associated with these injuries.

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