Laparoscopic Repair of Near Complete Traumatic Duodenal Transaction in an Eight Years Old Child: A Case Report

Abstract

Background: Traumatic duodenal perforation is a serious injury and is a result of major trauma and insult to the body. The management is difficult due to associated injuries and these children often need major resuscitation. The standard surgical treatment of traumatic duodenal perforation is laparotomy and repair of duodenal perforation. In children, laparoscopic repair of duodenal perforation is reported in only a few cases. Case: A repair of a near-complete duodenal transaction is not reported in the pediatric population. Herein, we report a case of an eight years old child who had a road traffic accident, and sustained multiple injuries and duodenal perforation, as confirmed by radiological evaluation including CT abdomen. The child was resuscitated, and later laparoscopy was performed, which showed gross bruising of the abdominal wall and a nearcomplete transaction at the level of 3rd part of the duodenum. Conclusion: Laparoscopic repair of the duodenum was performed using interrupted polyglycolic sutures. The child had a smooth post-op recovery and was discharged home in stable condition. At one-year follow-up, the child remained well and symptom-free. This case highlights the role of the safety of laparoscopic surgery in abdominal trauma and duodenal perforations.