Abstract
Three days before admission in a thirty-year-old man the left lower abdomen at the upper region of the inguinal ligament had been compressed by a fork-lift truck. He visited a doctor's office, there were no abnormal findings and nothing abnormal showed up on the X-ray at this time. He returned home and rested for 3 days. He visited our hospital with increasing abdominal pain and a high grade fever. His vital signs were stable and the left lower abdominal wound was mild, but bowel sounds were weak and the whole abdominal wall was hard. An abdominal X-ray and plain CT showed free air under the bilateral diaphragm and intra-mesenteric gas. A lower intestinal rupture was suspected and an emergency operation was performed. An approximately 1-cm long perforation of the mid-sigmoid colon was found at the mesenteric side surrounded by blunt mesenteric injury. Contaminations with feces was very mild and partial resection of sigmoidal colon and primary end-to-end anastomosis were carried out. Half of the diameter of the sigmoidal colon was ruptured at the mesenteric side of the resected specimen. A timely check-up is important in cases of mild abdominal blunt injury with no significant abdominal findings at onset.
