Laparoscopic Repair of Small Bowel Perforation Following Bullock Cart Run-over Injury in a 12-Year-Old Boy: A Case Report

Abstract

Small bowel perforation due to blunt abdominal trauma is an uncommon but serious condition that can result in peritonitis and sepsis if not promptly treated. The most frequent causes include motor vehicle accidents, bicycle handlebar injuries, and, in rare instances—particularly in rural India—bullock cart run-over injuries. Intestinal injuries are quite frequent after non-penetrating abdominal trauma. Small bowel and mesentery represent the most frequently involved structures in blunt abdominal trauma after liver and spleen. The frequency of small bowel lesions ranges from 5% to 15%. Small bowel mesenteric injuries are approximately found in 5% of patients after blunt abdominal trauma Timely diagnosis and surgical intervention are critical in managing this condition. Delayed recognition can lead to severe complications and poor outcomes. Diagnostic tools such as chest radiographs (to detect free air), abdominal ultrasonography, and computed tomography (CT) scans play a vital role in identifying intestinal perforations. Early surgical intervention significantly improves recovery rates, whereas diagnostic delays can result in prolonged treatment, increased morbidity, and even mortality. We report a rare case of small bowel perforation in a 12-year-old boy caused by a bullock cart run-over injury, which was successfully managed through laparoscopic surgery.