Intestinal Perforation Secondary to Blunt Inguinal Trauma in a Soccer Player: A Case Report

Small bowel perforation due to blunt trauma to an inguinal hernia: a case report and literature review

“…It has been shown previously by Reynolds [3] that direct trauma to an inguinal hernia can produce enough pressure to cause perforation of the intestinal walls, and this cause is in keeping with ours and other case reports that detail the injury as direct trauma to the hernia site itself [3][4][5][6][7][8][9]. Other theories in the literature state that any sudden and rapid increase in intra-abdominal pressure can lead to a perforation of a segment of bowel adjacent to the hernia due to the rigid aperture of the hernia leading to a greater rise in intra luminal pressure in this section of bowel [10].…”

“…The commonest area of perforation is the small bowel and more specifically the Ileum (60% Ileum, 10% jejunum, 4% colon) [10]. Our case is unique in the fact that, unlike most of cases in the literature [3][4][5][6][7][8][9][10][11][12], there were no overt clinical signs of bowel perforation, with an unremarkable abdominal examination, plain abdominal film and no pyrexia or tachycardia.…”

“…Vyas et al [2] found that the rate of traumatic intestinal perforation in patients with inguinal hernia is much higher than in healthy subjects. It is rarely reported, however, that perforation can occur following blunt trauma to the inguinal region in patients with a pre-existing inguinal hernia, as we have reported above [3][4][5][6][7][8][9][10].…”

“…It has been reported that performing serial physical examinations in the haemodynamically stable patient is the standard method for deciding whether there is a need for an operative procedure or not [8,13]. If the patient develops signs of peritonitis or becomes unstable then a surgical intervention is needed.…”

Delayed Small Bowel Perforation in a Pre-Existing Ventral Hernia After Blunt Trauma

“…There are a few cases reporting ventral hernias complicated by delayed perforation after blunt trauma but none that we have found involve small bowel perforation within the hernia after a CT scan without evidence of small bowel injury [ 4 ]. The literature demonstrates that the presence of a hernia can be a risk factor for bowel perforation [ 5 ]. One case study presented a 55-year-old man who suffered abdominal trauma playing soccer.…”