A RARE CASE OF PERFORATION OF SECOND PART OF DUODENUM – A CASE REPORT

Abstract

Perforation of the duodenum is a rare but potentially fatal injury. Duodenal perforations can be due to varied reasons, including peptic ulcer disease, iatrogenic causes, and trauma. Among these perforations of the second part of duodenum not pertaining to any of the above causes is a much rarer entity.Moreover a posterior wall perforation leading to retroperitoneal collection is a diagnostic dilemma. The most useful imaging approach for detecting duodenal perforation is computed tomography with intravenous and oral contrast. Surgical exploration may be required for diagnosis in some circumstances. The nature of the illness process that caused the perforation, the time, location, and extent of the injury, and the patient's clinical condition all influence the treatment. In stable patients with sealed perforations, conservative approach appears to be possible. Patients who present with peritonitis and/or intraabdominal sepsis necessitate immediate surgery. In certain patients with duodenal perforations, minimally invasive treatments are a safe and effective alternative to open surgery. Here we present one such rare case of second part of duodenum perforation not attributable to any of the aforementioned causes and free fluid confined to the retroperitoneal space.