A Rare Non-penetrant Abdominal Wall Injury Caused by High-pressure Water: A Case Report

High-pressure water jet injuries are an uncommon cause of trauma. Highpressure water injuries are usually seen at the extremities and less often in the thorax and abdominal areas. A review of the literature reveals a few case reports describing intraabdominal injuries due to penetrating trauma. İn this paper, we present the radiological findings of a rare case of abdominal wall injury without penetration of peritoneum caused by high-pressure water jet due to the Coanda effect. The Coanda effect is the tendency of a fluid jet to stay attached to a curved. In our case, the peritoneum also functions as flat and curved surface, causing non-penetrant abdominal wall injury.

A 28-year-old male working at a hydroelectric terminal presented to the emergency department with abdominal pain and a two-centimeter cutaneous gap in the left lower quadrant of the abdomen caused by high-pressure water. The CT findings revealed a small entrance to left lower quadrant of the abdominal wall and extensive subcutaneous injury. There was no internal injury. The cutaneous gap was managed by primary surgical closure. Subcutaneous emphysema was diminished on the follow up physical examination. The patient was recovered without sequelae.

The water jet can cause a wide subcutaneous injury by following the peritoneum even though there is a small entrance. Therefore radiological imaging can help to determine their severity and planning treatment.