Traumatic Gastric Perforation in Children From Blunt Trauma

Isolated double gastric rupture as a result of blunt abdominal trauma

“…Signs and symptoms of an acute abdomen are almost invariably present, but free intraperitoneal air on abdomen and chest films is seen only 16–66% of the time. 3 , 8 , 9 , 10 Our patient showed no pneumo-peritoneum on X-ray.…”

Gastric perforation following blunt abdominal trauma

“…Although shock on presentation has been reported as a fairly common occurrence, it was reported in < 20% of cases [3] . Vassey et al have suggested that aspiration of dark coloured fluid on peritoneal lavage or paracentesis is probably the best pre-operative diagnosis of gastric perforation [11] . Serum amylase has been suggested as a biochemical marker to diagnose upper gastrointestinal rupture [12] ; the unpredictability of this test makes this an unreliable diagnostic marker.…”

Isolated Gastric Rupture due to Blunt Trauma: An Interesting Case

“…Most of the perforations are solitary [5] and the common location for gastric perforations the anterior wall (40%) followed by the greater curvature (23%), lesser curvature (15%) and posterior wall (15%). However, the greater curvature is the site most often affected in the paediatric age group [8].…”

“…Patient must be taken for emergency surgery when suspicious features are seen on imaging or when there is shock, aspiration of dark coloured fluid on peritoneal lavage or paracentesis. This is diagnostic and must be followed by exploration [8]. The definite features of perforation on CT scan include, pneumoperitoneum, unexplained in traperitoneal fluid and other features like bowel wall thickening, and mesenteric fat stranding [9].…”