Sigmoid colon perforation secondary to blunt abdominal trauma from cow hoof.

INTRODUCTION

Abdominal discomfort is one of the most prevalent complaints presented to the emergency department. When making a clinical diagnosis, blunt trauma with substantial visceral injuries requires a high index of suspicion.

CASE PRESENTATION: The patient went to the emergency room after experiencing lower abdomen discomfort and a fever for two days. He was 40 years old. He says he was injured two days earlier when a cow foot landed on his stomach, causing mild blunt injuries. When examined, he is delicate all the way down in his lower belly. Results from the lab indicated a higher-than-normal total leucocyte count. Echogenic bowel thickening is seen on point-of-care ultrasonography (PoCUS) of the lower abdomen. Abdominal CT with contrast revealed oedema, heterogeneous enhancement, and a focal stretch of thickened circumferential mural including the sigmoid colon and peri-colonic fat stranding. Biopsy results from a sigmoidoscopy revealed significant sigmoid colon constriction and localized areas of active inflammation. Stricture development after a Sigmoid hole caused by a cow foot injury is an extremely unusual occurrence.

DISCUSSION: This case emphasizes the need of a thorough history and physical examination, especially in a high-pressure emergency scenario, and the value of using ultrasonography at the bedside to make a definitive diagnosis and improve patient care.

CONCLUSION

Regardless of the severity of abdominal damage caused by cattle collision, early imaging should be explored since delaying action might result in poor results.