Traumatic small bowel perforation
Diagnosis certain
Updates to Study Attributes
Findings
was changed:
Initial CT study shows intraperitoneal minute free gas foci "pneumoperitoneum" seen anteriorlyi.e pneumoperitoneum, anteriorly at the umbilical level with associated minimal free fluid, concerning for traumatic bowel injury
Right iliac bone comminuted fracture
Updates to Study Attributes
Findings
was changed:
Intraoperative, there was a small jejunal perforation about 100 cm from the DJ junction with intraperitoneal free fluid "succus".
Updates to Case Attributes
Body
was changed:
Bowel and pancreatic injuries are occasionally missed in imaging studies of abdominal trauma despite their critical sequellaesequelae. 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:
-
Assessmentassessment of parenchymatous organ injury should not distract attentionto thefrom potential bowel and pancreatic injuries -
Aa careful search for a pneumoperitoneum should be done -
Eveneven a minimal amount of pneumoperitoneum could be significant and requiring immediate surgery or at least close imaging follow up -
Lunglung window is helpful in the detection of pneumoperitoneum -
Inin 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
-<p>Bowel and pancreatic injuries are occasionally missed in imaging studies of <a href="/articles/abdominal-trauma">abdominal trauma</a> despite their critical sequellae. This case is an example of how occasionally difficult to detect a <a href="/articles/bowel-and-mesenteric-trauma">bowel injury</a> in a CT study. Here are some helpful tips:</p><ul>-<li>Assessment of parenchymatous organ injury should not distract attention to the bowel and pancreatic injuries</li>-<li>A careful search for a <a href="/articles/pneumoperitoneum">pneumoperitoneum</a> should be done</li>-<li>Even a minimal amount of pneumoperitoneum could be significant and requiring immediate surgery or at least close imaging follow up</li>-<li>Lung window is helpful in the detection of pneumoperitoneum</li>-<li>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</li>-</ul><p><em>Intraoperative image contribution by the surgeon Dr. Adel Abdelwahed</em></p>- +<p>Bowel and pancreatic injuries are occasionally missed in imaging studies of <a href="/articles/abdominal-trauma">abdominal trauma</a> despite their critical sequelae. This case is an example of how occasionally it is difficult to detect a <a href="/articles/bowel-and-mesenteric-trauma">bowel injury</a> in a CT study. Here are some helpful tips:</p><ul>
- +<li>assessment of parenchymatous organ injury should not distract attention from potential bowel and pancreatic injuries</li>
- +<li>a careful search for a <a href="/articles/pneumoperitoneum">pneumoperitoneum</a> should be done</li>
- +<li>even a minimal amount of pneumoperitoneum could be significant and requiring immediate surgery or at least close imaging follow up</li>
- +<li>lung window is helpful in the detection of pneumoperitoneum</li>
- +<li>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</li>
- +</ul><p>Intraoperative image contribution by the surgeon Dr Adel Abdelwahed</p>