Isolated Jejunal Perforation Following Bicycle Handlebar Trauma in an Adult: A Case Report

Öz

Isolated small bowel injury due to blunt abdominal trauma is uncommon and may present a diagnostic challenge, particularly when early clinical findings are subtle. Delayed diagnosis can result in severe complications, such as peritonitis, sepsis, intra-abdominal abscesses, and multiple organ failure. We report the case of a 50-year-old man who presented to the emergency department with abdominal pain after a bicycle accident involving direct handlebar impact to the anterior abdominal wall. Physical examination revealed abdominal tenderness, guarding, and rebound tenderness. Contrast-enhanced abdominal computed tomography revealed free intraperitoneal air, mesenteric fat stranding, and minimal free fluid, suggesting perforation of a hollow viscus. Emergency laparotomy revealed a full-thickness jejunal perforation approximately 130 cm distal to the ligament of Treitz without associated solid organ, colonic, or major mesenteric injury. The perforation was primarily repaired, and the patient recovered uneventfully. The patient was discharged on postoperative day 7 without complications. This case highlights the importance of maintaining a high index of suspicion for isolated small bowel perforation after bicycle handlebar trauma in adults and emphasizes the role of early surgical intervention when clinical and radiological findings suggest intestinal injury.

Anahtar Kelimeler

• blunt abdominal trauma
• jejunal perforation
• hollow viscus injury
• bicycle handlebar injury
• small bowel injury
• emergency laparotomy

Destekleyen Kurum

none

Etik Beyan

Ethics committee approval was not required for this single case report, as it describes the clinical course and management of an individual patient without any experimental intervention. Written informed consent was obtained from the patient for publication of this case report and the accompanying clinical and radiological images. All procedures were conducted in accordance with the ethical standards of the institutional and/or national research committee and with the principles of the Declaration of Helsinki.

Teşekkür

none

Erişkin Hastada Bisiklet Gidonu Travmasına Bağlı İzole Jejunal Perforasyon: Olgu Sunumu

Öz

Künt abdominal travmaya bağlı izole ince bağırsak yaralanmaları nadir görülmekle birlikte, erken dönemde klinik bulguların silik olabilmesi nedeniyle tanısal güçlük oluşturabilir. Tanıda gecikme peritonit, sepsis, intraabdominal apse ve çoklu organ yetmezliği gibi ciddi komplikasyonlara yol açabilir. Bu yazıda, bisiklet kazası sonrası gidonun karın ön duvarına çarpması nedeniyle acil servise başvuran 50 yaşındaki erkek hasta sunuldu. Fizik muayenede periumblikal hassasiyet, defans ve rebound saptandı. Kontrastlı abdominal bilgisayarlı tomografide anterior hepatik yüzey ve Morrison poşu komşuluğunda serbest intraperitoneal hava, alt abdominal kadranlarda mezenterik yağlı planlarda kirlenme ve minimal serbest sıvı izlendi. Bulgular intestinal perforasyon lehine değerlendirildi ve hastaya acil eksploratif laparotomi uygulandı. Cerrahi eksplorasyonda Treitz ligamentinden yaklaşık 130 cm distal jejunal segmentte tam kat perforasyon saptandı. Ek solid organ, kolon veya mezenterik yaralanma izlenmedi. Perforasyon alanı primer olarak onarıldı ve batın irrigasyonu yapıldı. Postoperatif takiplerinde komplikasyon gelişmeyen hasta yedinci günde taburcu edildi. Bu olgu, erişkin hastalarda bisiklet gidonu travması sonrası gelişen karın ağrısında izole jejunal perforasyonun akılda tutulması gerektiğini ve klinik-radyolojik şüphe varlığında erken cerrahi müdahalenin önemini göstermektedir.

Anahtar Kelimeler

• künt abdominal travma,
• jejenum yaralanması
• içi boş organ yaralanması
• bisiklet gidon yaralanması
• ince barsak yaralanması
• acil laparatomi

Destekleyen Kurum

yok

Etik Beyan

Bu çalışma tek olgu sunumu niteliğinde olduğundan ve herhangi bir deneysel girişim içermediğinden etik kurul onayı gerekmemektedir. Bu olgu sunumunun ve eşlik eden klinik/radyolojik görüntülerin yayımlanması için hastadan yazılı bilgilendirilmiş onam alınmıştır. Tüm süreçler kurumsal ve/veya ulusal etik standartlara ve Helsinki Bildirgesi ilkelerine uygun şekilde yürütülmüştür.

Teşekkür

yok

Kaynakça

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