Gastrointestinal Imaging

Trauma, small bowel

Trauma to the small bowel is usually due to blunt injury, e.g. in road traffic accidents. Penetrating trauma may cause perforation of or bleeding from the bowel wall (Fig.1). Only injuries to the spleen, liver and kidneys are more common. Patients may present with abdominal pain with or without peritonitis. Plain films of the abdomen may show pneumoperitoneum. Radiological findings include bowel wall thickening, extraluminal air, mesenteric haematoma, localised mesenteric streaking and intraperitoneal fluid.

Late complications include small bowel strictures, thought to be due to local ischaemic lesions.

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Fig.1

During drilling, a piece of the drillbit (arrowhead) broke off and penetrated the abdominal wall and small bowel, causing pneumoperitoneum (arrows).
Trauma, small bowel, Fig.1