Traumatic small bowel perforation


Bowel and pancreatic injuries are occasionally missed in imaging studies of abdominal trauma despite their critical sequelae. This case is an example of how occasionally it is difficult to detect a bowel injury in a CT study. Here are some helpful tips:

  • assessment of parenchymatous organ injury should not distract attention from potential bowel and pancreatic injuries
  • a careful search for a pneumoperitoneum should be done
  • even a minimal amount of pneumoperitoneum could be significant and requiring immediate surgery or at least close imaging follow up
  • lung window is helpful in the detection of pneumoperitoneum
  • in isolated traumatic small bowel injuries, the patient is usually vitally stable and complaining from abdominal pain only with a very low clinical suspicious about his injury

Intraoperative image contribution by the surgeon Dr Adel Abdelwahed