Small bowel and colon perforations following blunt abdominal trauma : a case report

Medical sciences

Small bowel and colon injuries are uncommon after blunt abdominal trauma. Repeated clinical assessment is important, especially when investigative imaging is negative. We report a case of 65-year-old male presented to the emergency department following a blunt abdominal trauma. No clinical or scanographic abnormality was found during his initial consultation. Four days later, he presented an increased abdominal pain with tachycardia; The x-ray of the abdomen showed a pneumoperitoneum and an emergent laparotomy was undertaken. Two perforations were found at the small bowel and sigmoid colon, repaired with sutures for the first and colostomy for the second. Patient was discharged home on day five. The diagnosis of small bowel and colon injuries is difficult and a low threshold of suspicion is crucial to reduce morbidity and mortality. Hemodynamic instability or abdominal tenderness after blunt abdominal trauma should be indications for immediate surgical exploration, despite negative imaging findings. Serial clinical assessment is the main decision tool to perform an abdominal exploration.

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