SQU Med J, May 2012, Vol. 12, Iss. 2, pp. , Epub. 9th Apr 2012 Submitted 20 th Sept 11 Revision Req. 13 th Dec 11, Revision recd. 25 th Dec 11 Accepted 25 st Jan 12 B lunt trauma can cause injuries to a variety of intra-abdominal organs. Solid organ injuries are more common than intestinal perforations 1 and are usually evident on presentation as these may be associated with varying degrees of shock or clinical signs of peritonitis. While perforation of the gastrointestinal tract is reported in 5–15% of patients, 2,3 it may be difficult to diagnose at initial presentation, especially if signs of peritonitis are minimal. Studies vary regarding the most common site of intestinal perforation; however, there is a consensus that isolated jejunal blow out (IJBO) is extremely rare. 4 Clinical presentation is usually delayed if the nature of the trauma is trivial. We report the case of a patient who presented with features of peritonitis 10 days after being injured by a knee kick trauma. An erect abdominal X-ray showed extraluminal air-fluid levels, suggesting a hollow viscous injury which on exploration was found to be IJBO. Case Report An 18-year-old male with no significant past medical or surgical history was brought to the emergency department 10 days after an incident of blunt trauma to the abdomen. e injury occurred when the patient swung from a great height and Sheikh Zayed Medical Complex, Rahim Yar Khan, Pakistan E-mail: drkhalidmunirbhatti@yahoo.com شعة ا معاءرج اسائل خا ال- واء مستوى ا بانفجار معزولطن مريض مصاب السينية لب لصائملمعي ا ل تقرير حالة نم دلاخ ، يتاهبقفلا وذ دم، يلع راس�فأا رمع، دلاخ نا، قاتس�مإا دم رونأا س�يرد ذرنبغي توخي ال�سائم. يلمعي ا لنفجار معزولى �سكل ابطن قد تظهر عل ال سابة كليلة ب�سيطة من اإ�ون يعانر�سى الذين ا�صة: ا لناق ال�سفاب التهاس عر�س اسخي�كن ت�أمرا�س. وإ�سابة با�س يزيد معدل ا اأو الت�سخي أخر العر�س أن تا الةه بتلك ا�ستبا ال�سديد ل من تعر�سهأيام ا10 ل�سفاق بعدب التهامح ا مع م َ مِ دَ عن حالة مري�س ق تقريرادرج هنا. نلبطنسعة ال�سينية لأ�يح بوا�سطة ا� عن ثقب ف والتيو سابة ع�سو اإ� اإا ي�س ، �سائل- ت هواءلوقوف م�ستوياطن بو�سع البسعة ال�سينية لأ�م. اأظهرت اأياة ا�ة بعكلة ركب بر ل�سائم.عي ا ثقب ا أنهاعد التنقيب ا ب تب قرير حالة، باك�ستان.ل�سفاق، تب التهائم، ال�ساء، ا أمعاخي�س، ثقب ا أخر الت�س �سدمة كليلة، تاكلمات:ح ال مفتا abstract: Patients with trivial blunt abdominal trauma may present with isolated jejunal blow out (IJBO). A high index of suspicion is required as delayed presentation or delayed diagnosis may increase morbidity. Presentation with frank perforation peritonitis can be diagnosed by abdominal X-rays. We report the case of a patient who presented with features of peritonitis 10 days after being injured by a knee kick trauma. An erect abdominal X-ray showed extraluminal air-fluid levels, suggesting a hollow viscous injury which on exploration was found to be IJBO. Keywords: Blunt trauma; Delayed diagnosis; Intestinal perforation; Jejunum; Peritonitis; Case report; Pakistan. Extra-luminal Air Fluid Level on Abdominal X-ray of a Patient with Isolated Jejunal Blow Out Case report *Khalid Munir Bhatti, Mohammed Zulfiqar Ali, Afshan Khalid, Umar Mushtaq, Mohammed Idrees Anwar CASE REPORT