Blunt abdominal trauma with bowel injuries

Case contribution: Dr Radhiana Hassan


  • a 23 years old man
  • Front passenger of a lorry, skidded and trapped in it
  • Vital signs are stable
CT scan abdomen in axial plane soft tissue window post contrast

CT scan findings:

  • A few lacerations within the spleen (red arrow). No extension to capsular region. No perisplenic blood collection
  • Fat streakiness surrounding left kidney. No parenchymal laceration. No contrast extravasation. Normal enhancement of both kidneys are seen.
  • Wall thickening involving small bowels (yellow arrows). No obvious discontinuity seen. No free air.
  • Wall thickening also seen involving the descending colon with focal blood pooling posterior to it (white arrows)

Intra-operative findings

  • showed small bowel perforation about 4 cm , 90 cm from DJ.
  • Serosal tear at descending colon with minimal contamination.
  • Minimal hemoperitoneum
  • The liver, spleen and kidneys are normal

Diagnosis: Blunt abdominal trauma with bowel, renal and splenic injuries.


  • Signs of bowel perforation such as free air and contrast material are virtually pathognomonic.
  • Bowel-wall thickening, free fluid, and mesenteric infiltration are other findings suggestive of bowel injury.

Progress of patient:

  • Patient also had Left AKA for crush injury of left LL
  • Recovered well
Author: radhianahassan