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

## TL;DR

A 5-year-old girl suffered a rare stomach rupture after a fall, requiring emergency surgery and intensive care.

## Contribution

Highlights the importance of early detection and surgical intervention in pediatric gastric perforation due to blunt trauma.

## Key findings

- CECT scan identified ascites and pneumoperitoneum, indicating hollow organ perforation.
- Emergency surgery revealed a 7 cm stomach laceration, successfully repaired with two-layer closure.
- Postoperative SIRS was managed in the PICU, leading to recovery and discharge within ten days.

## Abstract

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.