Injury to the duodenum following blunt abdominal trauma – Literature review and case report

Abstract

Abstract Introduction Injuries to the duodenum present a very serious diagnostic problem. Consequently, such are detected and treated in the very late stage, resulting in increased mortality rates. Such injuries account for 4.3% of all abdominal injuries. They often co-occur with injuries to other organs, and therefore are rarely found in isolation. Two types of injuries to the duodenum are differentiated: penetrating and blunt. Aim To present a case of duodenal injury following a blunt impact to the abdomen. Case study A female patient, 19 years of age, was admitted to the Clinical Department of General Surgery in a serious condition. The Emergency Response Team stated that this patient had reported severe abdominal pain in the epigastrium lasting for some hours and hematemesis. The patient's explanations as to the occurrence of injury were vague. A CT scan revealed injury to the duodenum. Results The patient was qualified for life saving surgery. Extensive transversal rupture of the anterior duodenal wall was detected. The injury was closed with double-layer tension-free sutures. Discussion The identified transversal rupture of the anterior duodenal wall was most likely the result of being beaten up or due to participation in a fight. Consequently, the patient experienced blunt injury to the abdomen causing the described trauma. Conclusions (1) We wish to emphasize the possibility of injury to the duodenum following blunt abdominal trauma that is difficult to diagnose and not always capable of being confirmed by information obtained during a patient interview as to its specific cause. (2) We draw attention to the necessity of taking a carefully detailed interview with the patient.