A 40-year-old man restrained with a lap belt sustains blunt abdominal trauma. He has a linear ecchymosis across the lower abdomen and develops fever and peritonism 24 hours later. Which structure is most commonly injured by this pattern of blunt trauma?
- A Jejunum near the ligament of Treitz ✓
- B Duodenum at the duodenojejunal junction
- C Sigmoid colon
- D Rectum below the peritoneal reflection
Correct answer: A. Jejunum near the ligament of Treitz
Explanation
Lap belt compression crushes the bowel against the vertebral column, and deceleration then produces shear at fixed points of attachment. The proximal jejunum just distal to the ligament of Treitz, being both relatively fixed and mobile distally, is the most frequently injured hollow viscus in blunt trauma. The sigmoid and infraperitoneal rectum lack the same fixation point mechanics, and duodenal injury more typically follows direct epigastric blows against the vertebrae.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.