JEJUNAL PERFORATION AFTER BLUNT ABDOMINAL TRAUMA: A SERIES OF 3 CASE

Abstract

Jejunal perforation caused by blunt abdominal trauma is uncommon and mostly seen after road traffic accident due to high energy deceleration injury. And it is also seen after bicycle handle injury, fall from height, and assault. Solid organ injuries are very much common after blunt abdominal trauma. Isolated jejunal perforations are very rare after blunt abdominal trauma. Therefore, if not identified early, it increases morbidity and mortality. Jejunal perforation are mainly due to increased intraluminal pressure in air and fluid filled bowel loops mainly on antimesenteric border. These perforations are called “Blowout” injury, mucosa will be protruding from perforation site and surrounding tissue destruction is less. It is also caused by shearing forces and also due to compression between the abdominal wall and vertebral column. Deceleration mechanism can result in a shearing of the serosa and muscularis throughout a segment of small bowel. Blunt abdominal trauma causing gastrointestinal perforation is very rare ranging from less than 1% to 8.5%, out of which isolated jejunal perforation occurs in less than 1% of cases.