Jejunal Tackle

Abstract

Jejunal perforation as a result of blunt abdominal trauma during sport is particularly rare. We are aware of 6 reported cases of jejunal perforation in sport: 1 in hockey, 2 in football (soccer), and 3 in American football. This report presents the case of a 25-year-old professional rugby union player, who presented to an "After Hours" general practice clinic with increasing central abdominal and epigastric pain after a heavy tackle during an international match in New Zealand. Despite suffering complete jejunal transection, the patient continued to play on, only presenting to an After Hours general practice clinic 3 hours after the injury. The case demonstrates the remarkable physiological resilience of professional rugby players and acts as a reminder to maintain a high degree of suspicion for small bowel injury despite normal vital signs in healthy young patients with abdominal pain secondary to blunt trauma.

Isolated complete jejunal transection following abdominal blunt trauma with delayed presentation

“…Most cases of small bowel perforations after blunt trauma occur as a result of motor vehicle crashes and falls from heights, and associated with multiple injuries. To the best of our knowledge, there have been only three reported cases of isolated jejunal transection following blunt abdominal trauma (bicycle handle bar, soccer, rugby) [2] , [3] making this case the first report of isolated, complete transection of the jejunum following a motor vehicle crash, with the longest delay in presentation reported in literature. The only similar report found was of a complete jejunal transection presenting 3 h post injury after a rugby game [2] .…”

“…Delayed presentation may occur if the bowel is not ruptured immediately and in such cases, sepsis may develop with increased mortality [6] . Complete jejunal transection presenting 3 h post injury after a rugby game has been reported [2] . Repeated studies have shown increased mortality rates to be directly related to delay in diagnosis [3] .…”