Silent rupture: The hidden danger of gastric perforation in paediatric blunt trauma: A case report

We present herein a case with the relatively uncommon presentation of isolated gastric perforation resulting from blunt trauma of the abdomen following a fall shortly after eating in a 5-year-old girl. The child experienced severe abdominal pain, tachycardia, hypotension, and shortness of breath. A physical examination revealed epigastric tenderness and abdominal distension. Initial X-ray was non-diagnostic, and a contrast-enhanced Computerised Tomography [CECT scan] demonstrated ascites and pneumoperitoneum that suggested hollow organ perforation. The emergency exploratory laparotomy revealed a 7 cm laceration on the stomach that was surgically repaired using two-layer closure. Following that, extensive peritoneal lavage occurred. In the postoperative period, the patient developed systemic inflammatory response syndrome [SIRS]. Hence, the PICU provided inotropic support and oxygen therapy. On the fourth day, she became significantly improved, and on the tenth day, we made her able to go home without any complications. The important points in the management of gastric perforation in paediatric blunt abdominal trauma are early suspicion, further imagination, and timely surgical intervention.