Delayed presentation of bowel obstruction after abdominal blunt trauma

Blunt abdominal trauma is a rare cause of small bowel obstruction thought to arise from either a sealed perforation of the small bowel or mesenteric injury resulting in adhesions. A 55-year-old gentleman presented with symptoms and signs of small bowel obstruction and a history of blunt abdominal trauma 14 months previously. Abdominal computed tomography showed a transition zone at the terminal ilium with proximal dilatation indicative of obstruction. At surgery, he had adhesions involving the terminal ilium with shortening and fibrosis of the supplying mesentery. Patients with a history of blunt abdominal trauma presenting with abdominal symptoms must be investigated to rule out bowel obstruction, with a low threshold for surgical intervention.