A Confusing Case of Pneumoperitoneum following Blunt Abdominal Trauma.

Abhinav Prakash Arya; Indra Singh Choudhary

Volume : V, Issue : XI, November - 2016

A Confusing Case of Pneumoperitoneum following Blunt Abdominal Trauma.

Abhinav Prakash Arya, Indra Singh Choudhary

Abstract :

A 20–years old male presented with history of blunt trauma abdomen in a road traffic accident with complaint of pain in the pelvis with in ability to pass the urine. Diagnostic imaging (Contrast Enhanced CT) revealed pelvic fracture with probable urethral injury along with free peritoneal air. Laparotomy was performed but no gastro–intestinal perforation could be identified and abdomen was closed. Patient was shifted to post–operative care and the nursing staff reported passage of blood per rectum over the bed–sheets 2 hours after the surgery. Digital rectal examination repeated and revealed blood stained finger. Patient was re–explored and during this exploration the deeper pelvis, which was initially obscured by pelvic hematoma, was examined thoroughly. A rent in anterior rectal wall identified and repaired primarily along with fashioning of proximal diverting loop colostomy.