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Traumatic colonic perforation

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Elderly gentleman. Driver in road traffic accident. Blunt trauma to abdomen. Generalized abdominal pain.

Patient Data

Age: 80 years
Gender: Male

Pericolonic inflammatory change in the mid-transverse colon.

Foci of extra-luminal gas.

Hemoperitoneum.

Pooling of contrast in the mesentery in keeping with a bleed.

Post operative gross specimen

Photo

Section of transverse colon and its mesentery.

Large hole on the anti-mesenteric surface - perforation.

Case Discussion

Road traffic accidents (RTA's) are one of the commonest cause of abdominal trauma - typically blunt.

Solid organ injuries are by far more common than intestinal injuries.  When the later occur, it is usually in association with a solid organ injury.

This is a rare example of an isolated colonic perforation, with an associated mesenteric tear/hemorrhage.

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