Small bowel perforation following blunt abdominal trauma caused by an accidental hammer blow: A case report

Abstract

Introduction. Trauma is among the leading causes of death. Undetected and untreated adequately and on time, traumatic small bowel injuries can be lethal. Case Report. We present a case of a small bowel perforation after a blunt abdominal injury, caused by an accidental self-inflicted hammer blow to the abdomen. The initial abdominal and chest x-rays and abdominal ultrasound did not indicate an injury to the abdominal organs. Due to the impaired clinical picture and the fact that the patient was hemodynamically stable, multi-detector computed tomography of the abdomen and small pelvis was performed, showing intraperitoneal free fluid and pneumoperitoneum, not seen by other imaging methods. A decision for surgical treatment was made. The intraoperative finding confirmed a small bowel perforation. Conclusion. Due to the possible false-negative imaging findings, clinical follow-up of patients with abdominal trauma is mandatory when making the decision for surgical treatment.