Small bowel laceration from a penetrating extraperitoneal gunshot wound: a case report.

Direct kinetic energy transfer from the path of a bullet may cause intraperitoneal injury even though the path of the bullet remains extraperitoneal. A 45-year-old man sustained a single through-and-through gunshot wound to the abdomen. The path of the bullet appeared superficial but clinically the patient had an acute abdomen. An exploratory laparotomy revealed no penetration of the peritoneum, but did reveal a perforation and contusion to the jejunum. To our knowledge this is the first reported case of a penetrating extraperitoneal gunshot wound with a blast injury to the small bowel.