A Case of Small─Intestinal Perforation by a Medicine Ball

Abstract

A 60-year-old male felt a pain in his lower abdomen during sit-ups performed using a 5 kg medicine ball placed on his lower abdomen by his trainer. The pain was initially tolerable, but then spread throughout the abdomen, and he therefore made an emergency visit to our hospital. Blood biochemistry tests showed no increase in C-reactive protein (CRP) level or leukocyte count. Abdominal CT images showed discrete free gas in the abdominal cavity, and the patient was diagnosed as having perforation of the digestive tract, although it was difficult to identify the perforation site. In emergency open surgery, a perforation site of 1.5×1.0 cm was found in the small intestine about 250 cm from the Treitz ligament, with intestinal fluid leaking from this site. Cleaning and drainage were performed, and the perforation site was sutured closed. Although there have been many case reports on small-intestinal perforation caused by blunt trauma of the abdominal region, this is the first case of digestive tract perforation caused by a medicine ball, based on our literature search. Healthcare and exercise personnel should understand that a training device can cause physical damage when it is not correctly used.