This case highlights the importance of vigilant clinical suspicion in diagnosing abdominal perforation. Intra-abdominal injury can be difficult to identify during competition, and timely diagnosis of jejunal perforation is difficult because of initially subtle clinical findings that gradually progress over time. Identifying intra-abdominal injuries early can improve the outcome of the patient. In-game evaluation did not identify this injury. The athlete completed the game, and the injury was ultimately identified with peritoneal signs and a negative Carnett sign, making abdominal wall injury less likely. The athlete underwent surgical repair of the perforation without complication and has since returned to full activity. It is important to maintain a high index of suspicion and to be observant with serial examinations, advanced abdominal examination maneuvers, and to have a broad differential diagnosis in the case of significant impact to the abdomen during athletics.