Hydroblast Injuries to the Small Bowel and Inferior Vena Cava

Hydroblast injuries occur from high-pressure water guns that are used for industrial cleaning. These instruments can generate pressures between 1,000 psi and 55,000 psi, delivering 60 gallons/minute of liquid at a velocity of 900 mph. Injuries from high-pressure water guns have been reported to involve the extremities and, less frequent, the abdomen, vasculature, chest, head, and neck. This case report describes a high-pressure water gun injury to the abdomen with injury to the jejunum and the first reported injury by this mechanism to the inferior vena cava. This case demonstrates that injury from high-pressure water guns can be more extensive than the visible wounds, indicating the need for an aggressive surgical approach. We present a review of the literature and outline the principles for evaluation and treatment.