Isolated proximal jejunal perforation near the ligament of Treitz following blunt abdominal trauma: a case report

Abstract Proximal jejunal injuries after blunt abdominal trauma are rare and challenging to diagnose early, with delayed recognition increasing morbidity. Management depends on hemodynamic status, injury severity, and contamination, with resection and primary anastomosis recommended when more than 50% of bowel circumference is compromised. A 38-year-old female sustained blunt abdominal trauma in a traffic accident and presented hemodynamically stable with peritoneal signs, leucocytosis, elevated inflammatory markers, and free intraperitoneal air. Laparotomy revealed a proximal jejunal perforation involving over 50% of the circumference, 10 cm distal to the ligament of Treitz. Segmental resection with primary anastomosis and abdominal lavage with two drains was performed. Recovery was uneventful, with bowel function returning on postoperative day (POD) 2 and discharge on POD 10. Follow-up confirmed full recovery. Early recognition and timely surgery are crucial, and primary anastomosis is safe in stable patients with significant circumferential injury.