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Isolated Cecal Rupture in Blunt Abdominal Trauma in a HIV Positive Patient

Alemayehu Ginbo Bedada1, Elijah W. Riddle2 Alemayehu Bekele Eshetu1, Georges Azzie3
1. University of Botswana, Faculty of Medicine, Gaborone, Botswana
2. University of Pennsylvania, Philadelphia, USA
3. Division of General and Thoracic Surgery, Hospital for Sick Children, Toronto Canada
Correspondence to: Dr. Alemayehu G Bedada; email: bedale00@yahoo.co.uk​

Summary

Cecal perforation following blunt abdominal trauma is an uncommon and challenging injury. We report a 19-year-old HIV-positive woman who presented with abdominal pain after a high-speed motor vehicle crash. Abdominal exam revealed a seatbelt sign with evidence of peritonitis and Focused Assessment with Sonography for Trauma (FAST) showed free intra-peritoneal fluid. After fluid resuscitation and antibiotics, the patient was taken for urgent laparotomy. Intraoperatively, we discovered hemoperitoneum and an isolated rupture of the cecum. A right hemicolectomy with end-to-end ileo-transverse colon anastomosis was performed. Her only significant post-operative complication was a superficial wound infection. We review the epidemiology of hollow viscus injury in blunt trauma and discuss important considerations in diagnosis and treatment.


Key words: Blunt abdominal trauma, Cecal rupture, HIV positive, Hollow viscus

Ann Afr Surg. 2020; 17(3):***

DOI: http://dx.doi.org/10.4314/aas.v16i1.*

Conflicts of Interest: None

Funding: None

© 2020 Author. This work is licensed under the Creative Commons Attribution 4.0 International License.

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