Huang HJ, Lin MJ, Li JT. Delayed rupture of a jejunal subserosa hematoma following blunt abdominal trauma: A case report and review of literature. World J Gastrointest Surg 2026; 18(5): 117395 [DOI: 10.4240/wjgs.v18.i5.117395]
Corresponding Author of This Article
Hong-Jun Huang, MD, Associate Chief Physician, Department of General Surgery, Central Hospital Affiliated to Shaoxing University, Shaoxing Central Hospital, No. 1 Huayu Road, Keqiao District, Shaoxing 312030, Zhejiang Province, China. zxyyhhj@usx.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
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/
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Huang HJ, Lin MJ, Li JT. Delayed rupture of a jejunal subserosa hematoma following blunt abdominal trauma: A case report and review of literature. World J Gastrointest Surg 2026; 18(5): 117395 [DOI: 10.4240/wjgs.v18.i5.117395]
World J Gastrointest Surg. May 27, 2026; 18(5): 117395 Published online May 27, 2026. doi: 10.4240/wjgs.v18.i5.117395
Delayed rupture of a jejunal subserosa hematoma following blunt abdominal trauma: A case report and review of literature
Hong-Jun Huang, Min-Jie Lin, Jiang-Tao Li
Hong-Jun Huang, Min-Jie Lin, Department of General Surgery, Central Hospital Affiliated to Shaoxing University, Shaoxing Central Hospital, Shaoxing 312030, Zhejiang Province, China
Jiang-Tao Li, Department of Hepatic-Biliary-Pancreatic Surgery, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
Author contributions: Huang HJ and Lin MJ performed surgical procedures; Huang HJ drafted the initial manuscript; Li JT contributed to supervision, writing, and reviewing the manuscript. The final draft was read and approved by all authors.
AI contribution statement: AI-enabled language tools, such as DeepL, ChatGPT were used for polishing and translation. All scientific content, analyses, interpretations, and conclusions were written by the authors. AI tools were not used to generate original manuscript text, only used occasionally to assist with translation. AI-enabled languageassistance tools were used exclusively for English language polishing and minor translation to improve clarity and grammar. They were not used for data analysis, interpretation, or substantive writing. This is solely a case report; the literature review and summary were completed entirely by the authors. The images are photographs taken by the authors during surgery and the patients’ computed tomography scans; none were AI-generated.
Supported by Shaoxing City Basic Public Welfare Plan Project, No. 2024A14030.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any 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 the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Hong-Jun Huang, MD, Associate Chief Physician, Department of General Surgery, Central Hospital Affiliated to Shaoxing University, Shaoxing Central Hospital, No. 1 Huayu Road, Keqiao District, Shaoxing 312030, Zhejiang Province, China. zxyyhhj@usx.edu.cn
Received: December 10, 2025 Revised: January 28, 2026 Accepted: March 2, 2026 Published online: May 27, 2026 Processing time: 173 Days and 0 Hours
Abstract
BACKGROUND
Traumatic subserosa hematoma of the proximal jejunum with delayed rupture and hemorrhage is exceedingly rare, especially without anticoagulation. No prior reports document spontaneous rupture precisely on day 5 post-blunt trauma. This case uniquely demonstrates this delayed pattern, initial computed tomography (CT) misdiagnosis as a retroperitoneal neoplasm due to Treitz ligament proximity, and conservative management failure, offering novel insights into its unpredictable course and the need for prompt surgical intervention in non-coagulopathic patients.
CASE SUMMARY
A 21-year-old male delivery courier sustained blunt upper abdominal trauma from a tricycle handlebar impact during a motor vehicle accident. Initial symptoms were mild abdominal pain and distension. Symptoms worsened on day 2 with nausea and vomiting; admission CT showed a retroperitoneal cystic mass with hemorrhage, misdiagnosed as duodenal gastrointestinal stromal tumor. Conservative management was initiated. On hospital day 4 (post-injury day 5), sudden severe pain, hypotension (90/45 mmHg), and tachycardia developed. Bedside ultrasound confirmed massive hemoperitoneum. Emergency laparotomy revealed a 10-cm ruptured subserosal hematoma at the proximal jejunum near the ligament of Treitz with active oozing; hematoma evacuation and serosal repair were performed. Postoperative course was uneventful; oral intake resumed on day 3, no contrast swallow X-ray was performed due to clinical stability, and he was discharged on day 7. One-month follow-up CT showed complete resolution.
CONCLUSION
This rare traumatic proximal jejunal subserosal hematoma ruptured on day 5 without anticoagulation, highlighting the need for early CT with Treitz focus, serial monitoring, and prompt laparotomy. This study is limited by its single-case, retrospective design and the lack of long-term follow-up data.
Core Tip: This exceedingly rare case of traumatic proximal jejunal subserosal hematoma without anticoagulation history demonstrates delayed rupture on day 5 after blunt abdominal trauma, leading to intraperitoneal hemorrhage despite initial conservative management. Initial computed tomography misdiagnosed it as a retroperitoneal cystic mass near the ligament of Treitz. Clinicians should maintain high suspicion in blunt trauma, perform early contrast-enhanced computed tomography focusing on Treitz fixation, conduct serial monitoring, and proceed to urgent laparotomy upon any sign of expansion or bleeding to prevent life-threatening complications.
