Traumatic small bowel obstruction
Famer hit in lower abdomen by a water buffalo. Increasing abdominal pain past 4 hours. Rigid abdomen.
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Moderate volume scattered foci of pneumoperitoneum.
Small amount of pelvic free fluid.
Several foci of gas along the right lateral side wall, suggests a small bowel perforation in the distal jejunum/proximal ileum is most likely.
Large bowel unremarkable.
Traumatic small bowel injuries are not terribly common and as in this case often occur in the context of blunt abdominal trauma. The cause of the trauma in this case is even less common.
This patient underwent an emergency laparotomy which identified a 1 cm perforation in the distal jejunum.