Akademik Veri Yönetim Sistemi
Clinics in surgery, cilt.2, sa.1664, ss.1664, 2017 (Hakemli Dergi)
Background: One of the most frequently injured hollow organs following blunt abdominal trauma is the jejunum; however, isolated jejunal perforation is rare.
Case Report: A 19 year-old male patient received a blow during taekwondo competition and admitted to emergency department with complaint of abdominal pain. Laboratory work-up and chest X-ray examinations did not reveal any pathology and the patient was discharged with recommendation of analgesics. Two days later, the patient presented to our emergency department with intense abdominal pain, nausea and vomiting with presence of abdominal tenderness, muscular defense, and rebound signs, whereas chest X-ray was completely normal. The patient was examined with computed abdominal tomography (CT), which revealed jejunal perforation. Following proper debridement, primary closure was performed. The patient was discharged on the postoperative 6th day.
Discussion: Although isolated intestinal injury after blunt abdominal trauma is extremely rare, it should certainly be considered particularly in cases with persistent abdominal pain. As it is particularly demonstrated in our case, failure to recognize hollow organ damage after blunt abdominal trauma by relying on the initially normal examination findings may lead to delay in the diagnosis for hours and even days as in our case. Considering that delayed diagnosis is an important cause of increased morbidity and mortality, we would like to remind that close follow-up of patients with repeated physical examinations and prolonging the hospital stay time have great benefits even if the initial examinations are normal.
Keywords: Abdominal trauma; Blunt; Jejunal perforation