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Isolated jejunal perforation (blowout) following motor vehicle accident

Author: 
Dr. Nasib Al Shibli.
Subject Area: 
Health Sciences
Abstract: 

Small bowel perforation may be suspected according to patient’s clinical presentation with high index of clinical suspicion, or existence of extra luminal air foci on diagnostic imaging usually performed to evaluate abdominal pain such as CT scan with double contrast or by help of focused abdominal Sonography for trauma (FAST) exam or diagnostic peritoneal lavage (DPL). Blunt traumatic perforation following motor vehicle accidents (MVA) can occur with severe abdominal trauma mostly related to part of the gastrointestinal tract is compressed against a fixed bony structure. Although single isolated perforation ( blowout) of the jejunum(IJP) following blunt abdominal trauma (BAT) is uncommon ,We present a case of isolated jejunal perforation (IJP) in a young Saudi male who was admitted to our facility with severe abdominal pain following MVA, although erect chest X-ray was unremarkable for free air abdominal CT scan revealed evidence of extra-luminal air foci (pneumoperitoneum).Exploratory laparotomy that followed revealed isolated 3 cm long perforation of the proximal jejunum, approximately 40cm from Treitz ligament and managed appropriately, so high index of suspicion and suitably timely surgical intervention led to successful outcome.

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