Traumatic small bowel perforation

Case contributed by RMH Core Conditions

Presentation

Struck by golf club.

Patient Data

Age: 65 years
Gender: Male

Intraperitoneal free gas, with free fluid, is suggestive of a traumatic bowel perforation.

A dilated loop of jejunum is demonstrated within the left side of the abdomen, subjacent to the subcutaneous bruising, with associated mesenteric hyperemia and stranding; whilst these features suggest that this is the site of bowel injury, no extravasation of orally administered contrast is seen, despite opacification of this loop of bowel.

Case Discussion

Bowel perforation was confirmed at surgery. Signs of traumatic bowel perforation can be non-specific and, in the absence of free gas or gross mural disruption, subtle on CT. 

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