Complete transection of the small intestine due to blunt abdominal trauma in a 3-year-old child: a case report

Abstract

Introduction

Complete transection of the small intestine following blunt abdominal trauma in children is extremely rare and poses diagnostic and therapeutic challenges.

Case presentation

A 3-year-old girl presented with abdominal pain, vomiting, and lethargy after suspected non-accidental blunt trauma. On arrival, the patient's vital signs showed tachycardia and fever. Physical examination revealed chest and epigastric ecchymoses, while abdominal ultrasonography revealed free fluid in Morison's pouch. Laboratory tests demonstrated marked transaminase elevation. Contrast-enhanced computed tomography showed free air and fluid in the perihepatic space and splenorenal fossa without evidence of liver injury. A diagnostic laparoscopy confirmed a complete jejunal transection approximately 2 cm distal to the ligament of Treitz with contaminated ascites, prompting conversion to open laparotomy. Approximately 5 cm of the jejunum were resected, followed by primary end-to-end anastomosis. The postoperative course was uneventful, and the patient was transferred to a child protection facility on postoperative day 6. Follow-up at 15 months confirmed normal recovery without complications.

Conclusion

Blunt abdominal trauma in young children can result in severe intestinal injuries that may have a delayed presentation.