Isolated Jejunal Perforation Following Bicycle Handlebar Trauma in an Adult: A Case Report

Isolated small bowel injury due to blunt abdominal trauma is uncommon and may present a diagnostic challenge, particularly when early clinical findings are subtle. Delayed diagnosis can result in severe complications, such as peritonitis, sepsis, intra-abdominal abscesses, and multiple organ failure. We report the case of a 50-year-old man who presented to the emergency department with abdominal pain after a bicycle accident involving direct handlebar impact to the anterior abdominal wall. Physical examination revealed abdominal tenderness, guarding, and rebound tenderness. Contrast-enhanced abdominal computed tomography revealed free intraperitoneal air, mesenteric fat stranding, and minimal free fluid, suggesting perforation of a hollow viscus. Emergency laparotomy revealed a full-thickness jejunal perforation approximately 130 cm distal to the ligament of Treitz without associated solid organ, colonic, or major mesenteric injury. The perforation was primarily repaired, and the patient recovered uneventfully. The patient was discharged on postoperative day 7 without complications. This case highlights the importance of maintaining a high index of suspicion for isolated small bowel perforation after bicycle handlebar trauma in adults and emphasizes the role of early surgical intervention when clinical and radiological findings suggest intestinal injury.