Perforation of gastroesophageal junction, stomach, and diaphragm following blunt abdominal trauma: A near miss: A case report. (April 2021)

• Record Type: Journal Article
• Authors: Koirala, Dinesh Prasad; Shrestha, Bibek Man; Kansal, Ankush; Poudel, Diptee; Neupane, Subita; Dahal, Geha Raj
• Is Part Of: International journal of surgery case reports. Volume 81(2021)
• Publication Date: 2021-04
• Subjects: Blunt abdominal trauma -- Gastro-esophageal junction -- Perforation; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2021.105786
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: Perforating intra-abdominal injuries are often fatal. We report perforating intra-abdominal organ injuries with rare GEJ perforation despite blunt trauma to the abdomen. Early suspicion and laparotomy to manage all the potential injuries along with effective resuscitation and prehospital care are critical. Esophageal perforations are common with high velocity automobile accidents, crush injuries and endoscopic interventions. Most common perforations occur along the cervical esophagus followed by distal esophagus. Abstract: Introduction: Blunt abdominal trauma causing Gastro-esophageal junction (GEJ), diaphragm, and gastric perforation in children is a very rare occurrence. However, the injury is serious and life-threatening with significant morbidity and mortality. Presentation of case: We report an unusual case of a 14-year-old boy with an accidental fall from the tree with blunt abdomen trauma with a perforating injury to GEJ, stomach, and diaphragm. Discussion: Multiple vital organs in the abdominal cavity are vulnerable to damage in blunt abdominal trauma. The rarity of perforation, diagnostic delay, and early septic occurrence sums up to higher patient morbidity and mortality. A high degree of suspicion and urgent laparotomy and surgical repair forms the cornerstone in management. Conclusion: Early suspicion along with effective resuscitation and early laparotomy and surgical repair is crucial for survival and optimal outcome of the patient.