Cho IS, Park CH, Lee JW. Double-sided gastric perforation after a motorcycle accident in Korea: A case report. World J Clin Cases 2025; 13(17): 98529 [DOI: 10.12998/wjcc.v13.i17.98529]
Corresponding Author of This Article
Jeong Woo Lee, MD, Assistant Professor, Division of Trauma Surgery and Surgical Critical Care, Department of Surgery, Keimyung University School of Medicine, Dongsan Medical Center, 1035 Dalgubeoldaero, Dalseogu, Daegu 42601, South Korea. johanleejw@gmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jun 16, 2025; 13(17): 98529 Published online Jun 16, 2025. doi: 10.12998/wjcc.v13.i17.98529
Double-sided gastric perforation after a motorcycle accident in Korea: A case report
In Soo Cho, Chan Hee Park, Jeong Woo Lee
In Soo Cho, Chan Hee Park, Jeong Woo Lee, Division of Trauma Surgery and Surgical Critical Care, Department of Surgery, Keimyung University School of Medicine, Dongsan Medical Center, Daegu 42601, South Korea
Author contributions: Cho IS contributed to formal analysis, investigation, software, and writing of the original draft; Park CH contributed to data curation, resources, and validation; Lee JW contributed to conceptualization, methodology, project administration, supervision, visualization, and review and editing of the manuscript.
Informed consent statement: The patient provided verbal informed consent for the publication of this case report and the accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read CARE Checklist (2016), and the manuscript was prepared and revised according to CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jeong Woo Lee, MD, Assistant Professor, Division of Trauma Surgery and Surgical Critical Care, Department of Surgery, Keimyung University School of Medicine, Dongsan Medical Center, 1035 Dalgubeoldaero, Dalseogu, Daegu 42601, South Korea. johanleejw@gmail.com
Received: July 2, 2024 Revised: November 9, 2024 Accepted: January 21, 2025 Published online: June 16, 2025 Processing time: 230 Days and 20.3 Hours
Abstract
BACKGROUND
Motorcycle accidents often result in abdominal trauma in patients seeking emergency care. Injuries to the hollow viscera, including the duodenum, jejunum, urinary bladder, and colorectum, are relatively common. In contrast, owing to the protective function of the anterior rib cage, gastric rupture is exceptionally rare, with an incidence of < 1.7%. Gastric rupture typically occurs in the anterior wall and rarely presents as multiple ruptures. This report describes an unusual case of multiple gastric ruptures resulting from blunt trauma.
CASE SUMMARY
A 21-year-old man, who was involved in a motorcycle collision at 70 km/hour after consuming a large meal, presented with hypotension. Physical examination revealed abdominal tenderness. Laboratory test results indicated elevated amylase, lipase, and liver enzyme levels. Computed tomography showed pneumoperitoneum, hemoperitoneum, and gastric wall discontinuation, suggesting gastric perforation alongside pancreatic, splenic, and hepatic injuries. Angiographic embolization was performed because of active contrast leakage in the left gastric and right gastroepiploic arteries. Emergency laparotomy revealed substantial blood loss, hematoma, and gastric contents scattered throughout the abdominal cavity. Two 10 cm gastric perforations in the anterior and posterior walls were identified, as well as severe liver damage, splenic injury, and pancreatic contusion. Surgical interventions included primary closure of the gastric wall, splenectomy, and partial hepatectomy. After temporary abdominal closure, the patient underwent a second surgery without further bleeding. The gastric repair site was resected and reinforced for optimal tissue healing.
CONCLUSION
Gastric rupture following blunt trauma is fatal. However, patients without severe complications can recover through surgical interventions and postoperative care.
Core Tip: Motorcycle accidents often result in abdominal trauma. Owing to the protective function of the anterior rib cage, gastric rupture is rare. We present a case of a 21-year-old man involved in a collision after consuming a large meal, leading to multiple gastric ruptures and pancreatic, splenic, and hepatic injuries. Surgical interventions included primary closure of the gastric wall, splenectomy, and partial hepatectomy. Despite the severity, the patient recovered after receiving appropriate postoperative care. This report underscores the importance of prompt surgical interventions for managing traumatic gastric injuries and ensuring favorable outcomes, even in complex cases.
