Perforation of the small bowel due to foreign body ingestion is a rare instance that occurs in less than 1% of all ingestions. Although rare, ingestion of blister pill packaging is becoming more recognised as a causative agent for intestinal perforation, but is very rarely reported to cause intestinal obstruction. This is a report of a 66-year-old woman who presented with intestinal obstruction and underwent laparotomy, revealing small bowel perforation by a piece of blister pill pack foil. The patient was incognisant of the ingestion.

Corpus luteal rupture is a common gynecologic cause for hemoperitoneum. Recent sexual intercourse is usually a preceding factor. However, postcoital hemoperitoneum without evident vaginal injury or trauma is rarely reported. We present a 34-year-old female who presented to the emergency department with severe bilateral lower quadrant abdominal pain after sexual intercourse. CT of the abdomen and pelvis revealed an intra-abdominal hematoma with extravasation of contrast questionable to be from one of the branches of the left internal iliac artery, and no adnexal abnormalities. Left internal iliac artery angiogram was performed and revealed no active extravasation. Exploratory laparotomy was performed and revealed an actively bleeding left ovarian ruptured area that was repaired and biopsied. No evidence of cysts was observed. Histopathological examination revealed a hemorrhagic corpus luteal cyst. Suspicion for corpus luteal rupture as a cause of postcoital hemoperitoneum should be maintained despite nonevidence of cysts on CT or intraoperatively.

In blunt trauma, diagnosis of small bowel injury is infrequent and accounts for less than 1.1% of blunt trauma admissions. Of those, only 0.3% are perforated.1 Isolated transection of the jejunum following blunt abdominal trauma has rarely been reported in literature.2,3 Most cases of small bowel perforations after blunt trauma occur as a result of motor vehicle crashes and falls from heights and are often associated with multiple injuries.4 This is a report of a 26 year-old female that presented 14 h after being involved in a motor vehicle crash and was found to have complete transection of her proximal jejunum with underlying mesenteric injury. Following the crash, the patient extricated herself from the vehicle, went home, and fell asleep with no significant complaints initially reported. She woke up hours later with severe abdominal pain and presented to our emergency department. CT was performed and revealed free fluid in the abdomen. Subsequently, an exploratory laparotomy was performed that revealed complete jejunal transection with underlying mesenteric injury. Isolated complete transection of the proximal jejunum should be considered in the evaluation of patients following blunt abdominal trauma, and presentation may be delayed up to 14 h. To the best of our knowledge, this is the first case report of complete transection of the proximal small bowel following a motor vehicle crash with the longest delay in presentation reported in the literature.