Bowel Trauma

  • Etiology: blunt abdominal trauma
  • Imaging: free air is rare, best signs are unexplained free fluid / focal bowel wall thickening and enhancement / focal bowel wall thickening with adjacent fluid present which should raise suspicion for sealed perforation
  • Clinical: in 1-9% of patients, commonly associated with lap belt ecchymoses
  • Note: pitfall is mesenteric laceration can result in free fluid

Cases of Bowel Trauma

CT of bowl trauma / bowel perforation
Initial axial CT with contrast of the abdomen (left images) shows no solid organ injury but a moderate amount of free fluid in the abdomen and pelvis. Repeat axial CT with contrast of the abdomen obtain a day later due to increasing abdominal pain (right images) shows a marked increase in the free fluid within the abdomen and pelvis.
Surgical image of small bowel perforation
Surgical image shows an ileal perforation with the forceps placed through the perforation.