A Case of Traumatic Duodenal Injury Caused by a Three-Point Seat Belt-Reconstruction with end-to-side duodenojejunostomy-

Abstract

An 18-year-old woman sustained a three-point seat belt injury in a vehicle accident and was admitted to our hospital complaining of abdominal pain. On examination at admission, the seatbelt sign was positive and there was tenderness in the right middle abdomen. Contrast-enhanced CT showed a defect in the wall of the descending part of the duodenum and free air outside the duodenum, and we diagnosed duodenal perforation. Diagnostic imaging also revealed liver injury and lung contusion, rib fractures, left tibial shaft fracture. An emergency laparotomy was performed. Intraoperative exploration revealed the perforation in the descending part of the duodenum, and we performed end-to-side duodenojejunostomy and cholecystectomy. A C-tube was placed for decompression. At the same time, we performed operation for reducing the tibial fracture. The patient was discharged after an uneventful clinical course on postoperative day 21. Traumatic duodenal injury caused by a three-point seatbelt is relatively rare, and we report a case herein, with a review of the literature.