Presentation
Elderly gentleman. Driver in road traffic accident. Blunt trauma to abdomen. Generalized abdominal pain.
Patient Data
Pericolonic inflammatory change in the mid-transverse colon.
Foci of extra-luminal gas.
Hemoperitoneum.
Pooling of contrast in the mesentery in keeping with a bleed.
Section of transverse colon and its mesentery.
Large hole on the anti-mesenteric surface - perforation.
Case Discussion
Road traffic accidents (RTA's) are one of the commonest cause of abdominal trauma - typically blunt.
Solid organ injuries are by far more common than intestinal injuries. When the later occur, it is usually in association with a solid organ injury.
This is a rare example of an isolated colonic perforation, with an associated mesenteric tear/hemorrhage.