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Isolated complete jejunal transection following abdominal blunt trauma with delayed presentation
Ghassan Al-Ramahi1, Mohamed Mohamed1, Kristin Kennedy1
1Trauma Services Department, Hurley Medical Center, One Hurley Plaza, Flint, MI 48439, USA.
Trauma Case Reports
|August 14, 2018
Summary
Diagnosis of small bowel injury after blunt trauma is rare. This case highlights a delayed presentation of jejunal transection following a motor vehicle crash, emphasizing the need for consideration in trauma evaluations.
Area of Science:
- Trauma Surgery
- Abdominal Injury
- Surgical Case Report
Background:
- Small bowel injuries are uncommon in blunt trauma, with perforations accounting for only 0.3% of cases.
- Isolated jejunal transection is a rare injury following blunt abdominal trauma.
- Most small bowel perforations result from high-impact events like motor vehicle crashes and falls.
Observation:
- A 26-year-old female presented 14 hours after a motor vehicle crash with severe abdominal pain.
- Initial presentation was delayed, with the patient experiencing no significant complaints immediately after the incident.
- Computed tomography (CT) revealed free fluid in the abdomen, prompting further investigation.
Findings:
- Exploratory laparotomy confirmed a complete transection of the proximal jejunum.
- An associated mesenteric injury was identified.
- This represents a rare instance of isolated complete proximal jejunal transection.
Implications:
- Clinicians should consider isolated complete proximal jejunal transection in patients with blunt abdominal trauma, even with delayed presentation.
- The possibility of a 14-hour delay in symptom onset and presentation should be recognized.
- This case report details the longest reported delay in presentation for this specific injury following blunt trauma.
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