Jejunal transection following trivial trauma: Case report and review of literature. (2016)

• Record Type: Journal Article
• Authors: Okello, Michael; Batte, Charles; Buwembo, William
• Is Part Of: International journal of surgery case reports. Volume 27(2016)
• Page Start: 41
• Page End: 43
• Publication Date: 2016
• Subjects: Blunt abdominal trauma -- Jejunal transection -- Laparotomy; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2016.06.027
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: Jejunal transection in patients with seemingly trivial abdominal injuries is rare but it can occur. It's possible to underestimate the severity of the injury during history taking thus a thorough evaluation is important for patients with blunt abdominal trauma. A well done clinical examination, abdominal ultrasound scan and erect chest x-ray to demonstrate a pneumoperitoneum are adequate for evaluation of patients with suspected hollow organ injury following blunt abdominal trauma in a resource limited setting. Abstract: Introduction: Severe hollow organ injury following trivial blunt abdominal trauma is uncommon. If it occurs it can easily be missed during routine clinical evaluation. Though less than ten cases of jejunal transection following trivial trauma have been reported in literature, this is the first case of jejunal transection occurring in a patient who fell while walking. Case presentation: We report a 32 year old female Ugandan, who walked into the emergency room due to abdominal pain following a fall while walking. She was found to be hemodynamically stable and was initially hesitant to do further investigations but finally accepted to go for abdominal ultrasound scan and a chest x-ray. Abdominal ultrasound scan noted free peritoneal fluid and erect chest radiograph revealed a pneumoperitoneum. She was admitted for an exploratory laparotomy. At laparotomy we found a complete jejunal transection with mesenteric laceration. Primary anastomosis was done; the patient had an uneventful recovery and was discharged on the tenth postoperative day. Discussion: Any trauma to the abdomen can potentially cause devastating injury to hollow viscera and should therefore be evaluated thoroughly. Conclusion: This case demonstrates that even in a resource limited setting, basic investigations like an abdominal ultrasound scan and erect chest radiographs are important when managing a patient with blunt abdominal trauma even though the injury seems trivial.