Delayed Small Bowel Perforation Following Blunt Abdominal Trauma as a Rare Cause of Acute Abdomen: A Case Report

We present a case of delayed small bowel perforation occurring 3 months after a blunt abdominal trauma. A 36 year old male sustained a steering wheel injury 3 months back. Computed tomography of the abdomen done after the trauma revealed only a mild peritoneal collection with a small non expanding mesenteric hematoma. He was managed conservatively. He now presented with features of acute abdomen since 2 days. Clinical and radiological investigations revealed a perforated viscous. He underwent exploratory laparotomy to reveal a phlegmon with multiple adhesions in the ileal loops with an underlying ileal perforation. The pathophysiological mechanism of such injuries causing a delayed presentation is unclear with only a few cases reported in the literature. We propose that delayed small bowel perforation following blunt abdominal trauma should be considered as a rare cause of acute abdomen.