Introduction. Isolated jejunal perforation (IJP) without any associated
injuries is rare in blunt abdominal trauma (BAT). It most commonly occurs in
decelerating trauma. Diagnosis of traumatic intestinal perforation may be
difficult in the first hours after injury so unrecognized ?missing?
intestinal injuries incidences are as high as 24%. Unrecognized traumatic
bowel perforation without adequate treatment leads to the intestinal leakage
into the peritoneal cavity, making progress in secondary peritonitis and
potentially lethal complications. Case outline. We presented the case of 43
years old women injured in road traffic accident. She was admitted to
emergency surgery after diagnostic procedures according to the protocol for
trauma. Initial examination, and body computed tomography (CT) revealed
orthopedic injuries. Daily monitoring and follow-up examinations were done,
she did not complain of any discomfort nor pain in the abdomen and there
were no signs of abdominal injury. Two days after trauma, follow-up
abdominal CT revealed highly suspected jejunum perforation, still with no
signs of pneumoperitoneum. Laparotomy was performed and diagnosis of IJP was
confirmed. Bowel perforation was surgically closed in two layers, followed
by drainage of septic collections, abdominal saline lavage and primary
abdominal closure. The patient was discharged on the seventh postoperative
day without complications. Conclusion. In the case of BAT due to severe
traumatic force in patient with nonspecific clinical signs of abdominal
trauma on initial clinical and radiological examination, follow-up in a
short period is necessary, to detect hidden jejunal perforation. Surgery is
a life-saving for those patients and treatment of these injuries usually
require simple operative procedures.
Isolated jejunal perforation - hidden danger in blunt abdominal trauma
