Summary Isolated injury to the intestine due to blunt abdominal trauma is an uncommon event. Since the haemodynamic disturbance which accompanies injury of the liver or spleen is absent the initial symptoms and signs may be very slight, or obscured by injuries of the abdominal wall, musculoskeletal or nervous systems. We present four cases which illustrate pitfalls in management. A high index of suspicion is essential if morbidity and mortality are to be reduced to a minimum. Abdominal radiography and peritoneal lavage are useful aids when diagnosis is in doubt.