Abstract
Cecal perforation following blunt abdominal trauma is an uncommon and challenging injury. We report a 19-year-old HIV-positive woman who presented with abdominal pain after a high-speed motor vehicle crash. Abdominal exam revealed a seatbelt sign with evidence of peritonitis; Focused Assessment with Sonography for Trauma showed free intraperitoneal fluid. After fluid resuscitation and antibiotics, the patient was taken for urgent laparotomy. Intraoperatively, we discovered hemoperitoneum and an isolated rupture of the cecum. A right hemicolectomy with end-to-end ileo-transverse colon anastomosis was performed. Her only significant postoperative complication was a superficial wound infection. We review the epidemiology of hollow viscus injury in blunt trauma and discuss important considerations in diagnosis and treatment.
 Keywords: Blunt abdominal trauma, Cecal rupture, HIV positive, Hollow viscus
Highlights
Isolated Cecal Rupture after Blunt Abdominal TraumaAlemayehu Ginbo Bedada,[1] Elijah Wade Riddle,[2] Alemayehu Bekele Eshetu,[3] Georges Azzie[4]
Hollow viscus injury (HVI) following blunt trauma is challenging and uncommon, presenting in 0.3–9% of cases (1-7)
Reported rates of HVI following blunt trauma vary by organ: small bowel is affected in 55.0–80.9% (1-3,5), colon in 10.0–17.0% (1,5,8), duodenum in 10–12% (1,5), rectum in 7.0% (1), stomach in 3.0–4.3% (1,5), cecum in 0.57% (2), and appendix in 0.4% (5) of cases
Summary
Alemayehu Ginbo Bedada,[1] Elijah Wade Riddle,[2] Alemayehu Bekele Eshetu,[3] Georges Azzie[4]. 1. Department of Surgery, University of Botswana, Faculty of Medicine, Gaborone, Botswana 2. Summary Cecal perforation following blunt abdominal trauma is an uncommon and challenging injury. We report a 19-yearold HIV-positive woman who presented with abdominal pain after a high-speed motor vehicle crash. Abdominal exam revealed a seatbelt sign with evidence of peritonitis; Focused Assessment with Sonography for Trauma showed free intraperitoneal fluid. A right hemicolectomy with end-to-end ileo-transverse colon anastomosis was performed. Her only significant postoperative complication was a superficial wound infection. We review the epidemiology of hollow viscus injury in blunt trauma and discuss important considerations in diagnosis and treatment
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