Case report emphasize pearls of duodenal perforation

病例报告强调了十二指肠穿孔的要点

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Abstract

INTRODUCTION: Isolated duodenal perforation secondary to trauma is a rare abdominal surgical condition, with a questionable surgical approach depending on the case. PRESENTATION OF CASE: This is a case report of a 27-year-old male patient who presented with a free perforation in the posterior wall of the third portion of the duodenal frame and secondary retropneumoperitoneum without injuring any contiguous organ, after a medium-impact blunt abdominal trauma during a soccer game. DISCUSSION: A laparotomy was performed, followed by duodenorraphy with Connell-Mayo suture and Lambert suture using vascular prolene in two planes. A nasogastric tube was placed up to the jejunum, and a Jackson-Pratt drain was placed in close to the duodenum next to the sutures. During hospitalization was found a positive bacterial culture of the peritoneal fluid hence received antibiotics, without complication. CONCLUSION: It is essential to make a timely diagnosis with its respective individualized surgical approach and it must be managed as an emergency surgical procedure.

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