Intestinal perforation due to isolated blunt abdominal trauma from work accident: A single center experience

Gures N., Kucuk O., ERGİNÖZ E., ULUDAĞ S. S.

ANNALS OF CLINICAL AND ANALYTICAL MEDICINE, no.1, pp.17-20, 2023 (ESCI)

Abstract

Aim: Isolated blunt abdominal trauma due to occupational accidents and related hollow organ injury is a very rare phenomenon. Therefore, their diagnosis can be difficult and delays in diagnosis can result in significant morbidity and mortality. In this study, we aimed to present cases of hollow organ injury caused by isolated abdominal blunt trauma due to work accidents. Material and Methods: Five male patients with isolated blunt abdominal trauma due to a work accident who applied to our center between 2017 and 2022 were included. Isolated blunt abdominal trauma occurred in three patients as a result of hitting a log, plank, and ax handle, and in one as a result of hitting a sack, and in one as a result of cow horn damage. Results: Ileal injury occurred in three patients, jejunal injury in one patient, and colonic injury in one patient. The average time for the onset of trauma to hospital admission varied between 3 to 60 hours. All patients developed acute abdominal signs, and abdominal CT showed abdominal free air, fluid, or a combination of both. One patient developed leukopenia, while other patients had significant leukocytosis. Primary repair was performed in two patients, loop ileostomy in two patients, and loop colostomy in one patient. Four patients were discharged and one patient died of sudden cardiac arrest. Discussion: Hollow organ injury may occur due to isolated blunt abdominal trauma from work accidents, and the findings can be easily missed. Delays in diagnosis can lead to significant morbidity and mortality. Primary repair in the early period and ostomy creation in delayed perforations may be treatment options in these patients.