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Small bowel perforation from blunt abdominal trauma is a common injury. Isolated perforation of the small bowel after blunt abdominal trauma is infrequent and the diagnosis can be elusive. A case of isolated perforation from blunt trauma is presented. Deterioration of the clinical picture raised suspicion of acute abdomen, perforated sore. If acute abdomen is the case even with a history of minimal abdominal trauma, delayed intestinal trauma should be considered in the diagnosis. The uses of various diagnostic procedures, such as chest radiograph for free air, abdominal ultrasonography and computed tomography for diagnosing intestinal perforation was reviewed. Serial abdominal examination continued to be paramount in diagnosing intestinal injuries. Explorative laparotomy revealed the perforation on the antimesenteric border. Early surgical intervention leads to good recovery. Sufficient vigilance and suspicions of small bowel perforation should always be considered after blunt trauma even when symptoms and physical findings are minimal. Diagnostic difficulties result in delayed surgical treatment and eventually in increased morbidity and mortality.