title: Paediatric case of a large gastric rupture after a blunt abdominal trauma: Report of a case in a District General Hospital.
abstract: BACKGROUND
  Isolated gastric rupture after blunt abdominal trauma is rare. In current literature gastric rupture from blunt abdominal trauma ranges between 0.02% and 1.7%. This document reports the first non-motor-vehicle case of an isolated gastric rapture after blunt abdominal injury, which repaired after early diagnosis and aggressive surgical treatment.
  
  
  METHODS
  A 14-year-old boy attended our emergency surgical department after sustained a blunt abdominal trauma following a fall from his bicycle. He presented with pain and left para-umbilical abdominal ecchymoses. Examination revealed subcutaneous emphysema and a palpable abdominal wall dimple.
  
  
  CONCLUSIONS
  Radiological examination with CT scan determined the need for exploratory laparotomy. Operation revealed, extensive rupture of the left lateral border of the rectus abdominus muscle, free intra-peritoneal position of the nasogastric tube with gross spillage of gastric contents and pneumo-peritoneum observed with 7-8cm full thickness rupture of anterior stomach wall, from the lesser towards the greater curvature. Primary, two-layer closure was performed. On the 5th post-operative day he developed gastrorrhagia. He was discharged on the 15th postoperative day.
  
  
  CONCLUSIONS
  We present this case report focusing on the paediatric patient to illustrate isolated gastric injury in terms of mechanism of injury, clinical presentation, and immediate surgical management.
authors.affiliation: Lewisham University Hospital, London Deanery, London, UK. Electronic address: pafitanis@gmail.com.
authors.forename: Georgios
authors.initials: G
authors.lastname: Pafitanis
authors.forename: Spiros
authors.initials: S
authors.lastname: Koulas
authors.forename: Stavros
authors.initials: S
authors.lastname: Bikos
authors.forename: Evangelos
authors.initials: E
authors.lastname: Tsimoyiannis