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Abstract

We report a rare case of four separate gastric ruptures resulting from blunt abdominal trauma that were successfully repaired by primary closure. A 22-year-old man injured in a motorcycle accident was admitted to our hospital where physical and radiological examinations confirmed the need for abdominal exploration. Laparotomy revealed four full-thickness lacerations in the anterior wall of the stomach. The lacerations were repaired primarily by a two-layer closure. The patient recovered gradually, and was discharged on hospital day 41, since when he has remained well. Although there has been no previous report of as many gastric lacerations following blunt abdominal trauma, surgeons should be aware of the possibility of multiple ruptures, which can be managed by simple closures.

Isolated Gastric Perforation following Blunt Trauma Abdomen not to be Missed: A Case Series

“…Consumption of a heavy meal before the injury is commonly seen in these cases because a distended stomach is less pliable and is more predisposed to rupture from blunt force. 4 One of our patients had a history of heavy meals which has led to a large perforation.…”

“…1 In the hemodynamically stable patient, the investigation of choice is a CT scan as it is accurate in detecting associated bowel, vascular, or solid organ injury. 4 Diagnostic peritoneal lavage, serum amylase can also be an adjunct in the diagnosis where CT is not available. 11,12 Ultrasonography has value in hemodynamically unstable patients in identifying intra-abdominal fluid which strongly suggests free blood and an indication for laparotomy.…”