A case of traumatic perforation of a duodenal parapapillary diverticulum

Abstract

A 59-year-old woman who transported with upper abdominal bruising was diagnosed with traumatic duodenal injury and underwent emergency surgery. The mucosa in the perforated area showed a saccular protrusion, and she was diagnosed with traumatic perforation of a duodenal parapapillary diverticulum. We resected the diverticulum and partially trimmed the perforation site, and the area was closed and covered using the greater omentum. We placed a drain and performed transgastric duodenostomy for decompression and a jejunostomy tube for nutritional support. The patientʼs postoperative course seemed good; however, she developed fever on postoperative day （POD） 11. We observed anastomotic leak and observed with decompression of the duodenum. Her condition improved, and she was functionally independent at discharge on POD 56. Traumatic perforation of a duodenal diverticulum is rare, and appropriate management is yet to be determined. We used transgastric duodenostomy and jejunostomy tube placement for management of complications in this case.