A 25 year old man presented with head trauma after falling from his bike in a road traffic accident. He was not wearing a helmet. He also complained of bleeding from his right ear and loss of consciousness for a few minutes after the fall.
The sonogram of the abdomen performed with a high frequency linear probe shows a linear hyperechoic structure within the small bowel lumen giving the 'tram track' appearance. This structure was seen to move with peristalsis.