Traumatic jejunal perforation
26 year old male patient came to the ER after heavy object fell on him.
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Post IV contrast axial, sagittal and coronal reformatted images show thickened wall jejunal loop with air bubble adjacent to the thickened wall, mild free abdominopelvic fluid as well as free air seen under the diaphragm and in the porta hepatis.
Presence of extraluminal air and free fluid after blunt abdominal trauma have a high sensitivity and specificity of bowel perforation. Thickened bowel loop with adjacent extraluminal air focus can point to the site of perforation.
At least one-half of injuries to hollow viscera involve the small bowel, followed in frequency by the colon and stomach. The segments affected most commonly are the proximal jejunum (distal to the ligament of Treitz) and the distal ileum (proximal to the ileocecal valve).
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