Incidental small bowel perforation in an isolated head injury

Spontaneous gastrointestinal perforation is a rare occurrence, most associated with an infectious cause precipitated by an underlying co-morbidity. This case report discusses a 39-year-old trauma patient that sustained an isolated gunshot to his face. The patient subsequently developed spontaneous bowel perforations of the duodenum and ileum while intubated in ICU. Despite extensive laboratory and histopathological testing, no definitive etiology was identified. This case report highlights the importance of suspecting and recognizing bowel perforation and abdominal compartment syndrome promptly in an intubated ICU patient. The report emphasizes the necessity of early surgical source control and the role histopathology plays in diagnosis of underlying pathologies. This case contributes to the limited literature surrounding spontaneous gastrointestinal perforation where the etiology is inconspicuous.