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Am J Emerg Med. 2009 Nov;27(9):1177.e1-3. doi: 10.1016/j.ajem.2009.02.018.

Late presentation of jejunal perforation after thoracic trauma.

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  • 1Department of Surgery, Larissa University Hospital, 41 110 Mezourlo, Larissa, Greece.


Jejunal perforation is extremely rare in trauma especially without initial involvement of the abdomen. We present the case of a delayed jejunal perforation after thoracic trauma with no initial indication of abdominal trauma in a 55-year-old man who was admitted to our department after a road traffic accident. The patient sustained thoracic trauma with rib fractures of the left hemithorax and hemopneumothorax and a mild head injury. On the fourth day of his in-hospital stay, he complained of severe abdominal pain and signs of acute abdomen were observed. He underwent emergency laparotomy where a perforation of the jejunum near the ligament of Treitz was noticed and sutured. His postoperative recovery was uneventful. Physicians treating trauma should always have a high degree of suspicion regarding rare abdominal injuries, with delayed presentation, even if no abdominal involvement is noticed during the initial survey.

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