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Traumatic complete pyloric transection following blunt abdominal trauma: A case report and literature review

Khac Thao Thai1, Trong Hoe Nguyen1, Thanh Son Le2

  • 1Department of Gastrointestinal Surgery, Military Hospital 103, Hanoi, Vietnam.

Medicine
|August 22, 2026
PubMed
Abstract

Insights

Severe blunt abdominal trauma can cause rare gastric rupture, including complete pyloric transection. Prompt diagnosis via computed tomography and surgical repair are crucial for favorable outcomes in complex gastric injuries.

Area of Science:

  • Trauma Surgery
  • Surgical Gastroenterology
  • Emergency Medicine

Background:

  • Gastric rupture from blunt abdominal trauma is rare.
  • Complete pyloric transection is an exceptionally uncommon gastric injury.
  • Early diagnosis and surgical intervention are vital to prevent septic complications.

Purpose of the Study:

  • To report a rare case of complete pyloric transection following blunt abdominal trauma.
  • To highlight the diagnostic value of whole-body contrast-enhanced computed tomography (CT) in polytrauma.
  • To emphasize the importance of timely surgical management for complex gastric injuries.

Main Methods:

  • A 31-year-old male with severe abdominal pain after a motorcycle collision was evaluated.
  • Whole-body contrast-enhanced computed tomography revealed pneumoperitoneum and gastric rupture.
  • Emergency laparoscopy converted to laparotomy identified complete pyloric transection and other injuries.
  • The patient underwent distal gastrectomy with Roux-en-Y reconstruction and peritoneal lavage.

Main Results:

  • The patient's postoperative course was favorable with resumption of oral intake on day 5.
  • Discharge occurred on postoperative day 20 in stable condition.
  • At 30-day follow-up, the patient had normal eating and bowel habits with a healed anastomosis.

Conclusions:

  • Whole-body contrast-enhanced CT is valuable for early evaluation of blunt polytrauma.
  • Clinical deterioration should guide operative decisions when CT is inconclusive.
  • Prompt resection and reconstruction are essential for favorable outcomes in complex gastric injuries like complete pyloric transection.
Keywords:
blunt abdominal traumacomputed tomographyemergency surgerygastric rupturepyloric transection

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