Combined stomach and duodenal perforating injury following blunt abdominal trauma: A case report and literature review

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Abstract

Background: Gastrointestinal injury following blunt abdominal trauma is uncommon; a combined stomach and duodenal perforating injury is even more rare. Because these two organs are located in different spaces in the abdomen, such injuries are difficult to identify. Case presentation: A young woman involved in a motor vehicle crash presented to our emergency department with concerns of severe peritonitis. Contrast-enhanced computed tomography of the abdomen revealed pneumoperitoneum and retroperitoneal hematoma in zone 1. An emergency laparotomy was performed, revealing a stomach-perforating injury, which was resolved with primary repair. No obvious injury was observed on retroperitoneal exploration. However, peritonitis presented again on the second postoperative day, and a second laparotomy was performed, revealing a duodenum-perforating injury in its third portion. We performed primary repair with multi-tube-ostomy. The patient recovered well without permanent tube placement or internal bypass. Conclusions: Assessing associated injuries in blunt abdominal trauma is crucial because they may be fatal if timely intervention is not undertaken. These types of complicated injuries require a feasible surgical strategy formulated by experienced surgeons, which gives the patient a better chance of survival.

Original languageEnglish
Article number217
JournalBMC Surgery
Volume20
Issue number1
DOIs
Publication statusPublished - Oct 2 2020

Keywords

  • Blunt abdominal trauma
  • Duodenum perforation
  • Handle-bar injury
  • Retroperitoneal hematoma
  • Stomach perforation

ASJC Scopus subject areas

  • Surgery

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