Published: 2016-12-13

A rare case of isolated transverse colon perforation following blunt trauma abdomen-case report with review of literature

Prateek Thakur, Shekhar Gogna, Priya Goyal


Colon injury is far more common in penetrating injury than blunt trauma abdomen. Blunt trauma to the abdomen is more likely to damage solid organs such as the liver, spleen, pancreas and kidneys. Colon injury in blunt trauma is severe and is associated with other organ, making its diagnosis difficult. However, isolated transverse colon injury in blunt trauma is rare. We report a case of 62 year old female who presented to us with blunt trauma to abdomen following motor vehicle accident. The patient was having tenderness and guarding all over abdomen. X-ray abdomen was normal, ultrasonogrm of abdomen showed presence of free fluid. Patient was operated on clinical basis. A single perforation of size 2 cm×1 cm was present in transverse colon on and there was no other injury. The perforation was primarily closed. Isolated transverse colon injury is rare presentation. Initial radiologic investigations may be misleading. Most of the injuries can be managed with primary repair in absence of gross contamination and shock.


Blunt trauma abdomen, Isolated transverse colon injury, Treatment

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Yi-Xiong Zheng, Li Chen, Si-Feng Tao, Ping Song, Shao-Ming Xu. Diagnosis and management of colonic injuries following blunt trauma. World J Gastroenterol. 2007;28;(13):4.

Schimpl G, Schmidt B, Sauer H. Isolated bowel injury in blunt abdominal trauma in childhood. Eur J Pediatr Surg. 1992;2:341-4.

Ricciardi R, Paterson CA, Islam S, Sweeney WB, Baker SP, Counihan TC. Independent predictors of morbidity and mortality in blunt colon trauma. Am Surg. 2004;70:75-9.

Dauterive AH, Flancbaum L, Cox EF. Blunt intestinal trauma. A modern-day review. Ann Surg. 1985;201:198-203.

Vance B. Traumatic lesions of the intestine caused by non-penetrating blunt force. Arch Surg. 1923;7:197-212.

Fakhry SM, Brownstein M, Watts DD. Relatively short diagnostic delays (<8 hours) produce morbidity and mortality in blunt small bowel injury: analysis of time to operative intervention in 198 patients from a multicenter experience. J Trauma Inj Infect Crit Care. 2000;48:408-14.

Sikka R. Unsuspected internal organ traumatic injuries. Emerg Med Clin North Am. 2004;22:1067-80.

Goletti O, Ghiselli G, Lippolis PV. The role of ultrasonography in blunt abdominal trauma: results in 250 consecutive cases. J Trauma. 1994;36:178-81.

Pasquale M, Fabian TC. Practice management guidelines for trauma from the Eastern Association for the Surgery of Trauma. J Trauma. 1998;44(6):941-56.

Nelson R, Singer M. Primary repair for penetrating colon injuries. Cochrane Database Syst Rev. 2003;(3):CD002247.

Causey MW, Rivadeneira DE, Steele SR. Historical and current trends in colon trauma. Clin Colon Rectal Surg. 2012;25:189-99.

Moore EE, Cogbill TH, Malangoni MA, Jurkovich GJ, Champion HR, Gennarelli TA, et al. Organ injury scaling, II: pancreas, duodenum, small bowel, colon, and rectum. J Trauma. 1990;30:1427-9.