Isolated Cecal Rupture after Blunt Abdominal Trauma

Alemayehu Ginbo Bedada,1 Elijah Wade Riddle,2 Alemayehu Bekele Eshetu,3 Georges Azzie,4

  1. Department of Surgery, University of Botswana, Faculty of Medicine, Gaborone, Botswana

  2. Department of Surgery, University of Pennsylvania, Philadelphia, USA

  3. Department of Pathology, University of Botswana, Faculty of Medicine, Gaborone, Botswana

  4. Division of General and Thoracic Surgery, Hospital for Sick Children, Toronto,Canada

Correspondence to: Dr. Alemayehu 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; Focused Assessment with Sonography for Trauma showed free intraperitoneal 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 postoperative 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.

 

Keywords: Blunt abdominal trauma, Cecal rupture, HIV positive, Hollow viscus

 

Ann Afr Surg. 2020; 17(3):134–136

DOI: http://dx.doi.org/10.4314/aas.v17i3.11

Conflicts of Interest: None

Funding: None

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

Submitted: 4 August 2019

Revised: 9 December 2019

Accepted: 28 January 2020

Online first: 29 May 2020

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