Case Presentation: A 13-year-old female patient presented with anterior abdominal and posterior lumbar pain at rest and on palpation after being in a road traffic accident with a high-speed truck. Initial examination: “Seatbelt” abrasion across her abdomen Vitals – Stable Cervical, head, chest, and abdomen CT – No findings Post-injury day six: Persistent abdominal & lower back pain and reduced bowel movements Abdominal CT— Small bowel obstruction Skeletal injuries — Negative Laparoscopy (diagnostic) — No signs of trauma, obstruction Post-injury day eight: Presented to the casualty department with vomiting Abdominal X-ray — Post-operative ileus vs.
mechanical obstruction Post-injury day 11: CT— Post-operative ileus vs. mechanical obstruction L3-L4 spinous process widening ( Cover image 1a ) Spine exam — Palpable step off between lumbar spine process with tenderness to palpitation…
