Evaluation and surgical repair of retroperitoneal duodenal perforation following blunt trauma: A case report

Isolated horizontal duodenal injuries resulting from blunt abdominal trauma are exceedingly rare, primarily due to the retroperitoneal location of the duodenum. This anatomical characteristic often leads to delayed diagnoses. A 61-year-old man presented to the emergency room following an assault by a bull. He complained of severe abdominal pain, vomiting, and fever. Imaging revealed a perforation on the anterior wall of the third part of the duodenum. However, during the laparotomy after Kocherisation (a way of exposing the duodenum to get better access), an additional posterior wall perforation at the same duodenal site was identified. Tension-free transverse primary repair was performed for the anterior and posterior wall perforations, with duodenal decompression procedures. Drains were placed accordingly. The patient recovered well, with gradual resumption of feeding and subsequent removal of drains. He was discharged after 15 days, demonstrating successful recovery without complications.