Traumatic small bowel injury

Case contributed by Dr Andrew Dixon

Presentation

High speed car accident.

Patient Data

Age: 40
Gender: Male

Lower abdominal subcutaneous seat belt bruise. Small volume free intraperitoneal fluid including subtle fluid interposed between small bowel loops. Trace hematoma adjacent to the junction of the descending colon and sigmoid.

Several small locules of free intraperitoneal gas are seen near the umbilicus consistent with traumatic bowel perforation. 

Case Discussion

Subtle seat belt related bowel perforation confirmed to involve the small bowel at surgery. 

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