title: Delayed small bowel perforation following blunt abdominal trauma: A case report and review of the literature.
abstract: We report a case of delayed presentation of a small bowel perforation following blunt abdominal trauma (BAT). An initial computed tomography (CT) scan revealed that the patient (a 32-year-old man) had a mesenteric hematoma, which was managed conservatively. Four weeks later, he returned to the hospital complaining of abdominal pain. A CT scan of the abdomen showed a thickened loop of the small bowel adjacent to the mesenteric hematoma at the level of the ileum. He was discharged home, but re-presented with acute abdomen 6 weeks post-trauma. An exploratory laparotomy was performed, which showed a perforated thickened loop of the ileum forming a phlegmon in the lower abdomen. In the English medical literature, only eight other reports of delayed post-traumatic presentation of ileal/jejunal perforation following BAT have been reported. We propose that post-traumatic intestinal perforation be considered in the differential diagnosis even in patients who experience a delayed small bowel perforation following BAT.
authors.affiliation: Department of Surgery, Louisiana State University Health Shreveport, Shreveport, LA, USA.
authors.forename: Alireza
authors.initials: A
authors.lastname: Hamidian Jahromi
authors.affiliation: Department of Surgery, Louisiana State University Health Sciences Center, E A Conway Medical Center, Monroe, LA, USA.
authors.forename: Lester
authors.initials: L
authors.lastname: Johnson
authors.affiliation: Department of Surgery, Louisiana State University Health Shreveport, Shreveport, LA, USA. Electronic address: ayouss@lsuhsc.edu.
authors.forename: Asser M
authors.initials: AM
authors.lastname: Youssef
mesh_terms: D000007:Abdominal Injuries / Q000150:complications / Q000000981:diagnostic imaging*; D000328:Adult; D006406:Hematoma / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D007416:Intestinal Perforation / Q000000981:diagnostic imaging* / Q000209:etiology; D007421:Intestine, Small / Q000000981:diagnostic imaging / Q000293:injuries; D008297:Male; D008643:Mesentery / Q000000981:diagnostic imaging* / Q000293:injuries*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000000981:diagnostic imaging*
keywords: blunt abdominal trauma; bowel perforation; delayed presentation; mesenteric hematoma; small bowel