Multiple Small-Bowel Perforations Following a Stab Wound and Challenges in Managing a High-Risk Trauma Patient: A Case Report

Penetrating abdominal trauma carries significant morbidity, and the occurrenceof multiple small-bowel perforations is particularly uncommon. We report thecase of a 28-year-old male who presented with anterior abdominal eviscerationof small bowel and mesentery following a knife assault. He arrived in class IIIhypovolemic shock and underwent an emergency laparotomy. Five distinctsmall-bowel perforations were identified and managed successfully which is veryrare. His initial postoperative recovery was uneventful, and ileostomy reversalwas performed four months later. The reversal was complicated by a localizedanastomotic leak, which was managed conservatively with complete resolution.This case highlights that even multiple small-bowel perforations resultingfrom penetrating trauma can be effectively managed with timely resuscitation,appropriate surgical repair, and staged reconstruction, leading to a favourableoutcome.