2016 Volume 36 Issue 7 Pages 1193-1196
A 70-year-old drunk man who had stumbled and fallen into a canal was brought to our hospital. CT revealed a lumbar fracture, therefore, the patient was admitted to the orthopedics department. However, he developed abdominal pain on the following day, which persisted until the day after. A repeat abdominal CT revealed duodenal perforation and a retroperitoneal abscess. Emergency operation was performed. Intraoperative findings revealed a perforation about 5 mm in diameter in the third portion of the duodenum and widespread right retroperitoneal cavity. Simple closure with catheter jejunostomy was performed with abdominal drainage. Suture leakage occurred 9 days after the surgery. Manual lavage and drainage were performed for about half a year. Traumatic injury of the duodenum is often difficult to diagnose quickly, however, with delayed surgery, the risk of leakage and the associated morbidity and mortality are high. Various sophisticated procedures (pyloric exclusion, duodenal diverticulization and so on) have been performed. However, more recent reports show that sophisticated procedures are not required even in patients with severe injuries. In this paper, we present our experience of a case of traumatic duodenal injury and retroperitoneal abscess, together with a review of the literature.
