It has been recognized for hundreds of years that nonpenetrating trauma of the abdominal wall may cause intestinal perforation. The trauma need not be particularly severe, and frequently it causes no gross lesion of the abdominal wall itself. In view of the tremendous number of adequate injuries sustained every day by any large group of workers, the conclusion is inescapable that a special combination of circumstances must be present to cause actual perforation. Presumably the loop of intestine must be filled with either fluid or gas and must be fixed against an unyielding portion of the posterior abdominal wall, so that it cannot slip out of the way of the traumatizing force; this in turn implies a force acting in just the right direction.
The importance of this uncommon lesion lies in the disparity between the apparent triviality of the blow and the serious consequences of a failure in diagnosis.
HUNT GH, BOWDEN JN. RUPTURE OF INTESTINE CAUSED BY NONPENETRATING TRAUMA OF THE ABDOMINAL WALLA REPORT OF CASES. Arch Surg. 1944;49(5):321-326. doi:10.1001/archsurg.1944.01230020330003