Abstract
A 6-year-old girl fell during cycling and sustained a bruise in the upper abdomen with being struck by the handles. Presenting with hemorrhagic shock symptoms on examination, the patient underwent laparotomy 20 hours after the accident. Intraperitoneal hemorrhage and duodenojejunal intramural hematoma with a perforation of the duodenojejunal flexture were found, and therefore, partial duodenojejunectomy and side-to-side duodeno-jejunostomy were performed. The postoperative course was uneventful and the patient was discharged 18 days postoperatively.
In children, even a slight blunt external force applied to the abdominal region may cause a serious organ damage as it was shown in this case. It should also be remembered that the duodenal perforation (particularly a retroperitoneal duodenal perforation) may follow an asymptomatic or mild course for a time. When a duodenal injury is suspected at laparotomy, it is necessary to perform sufficient mobilization of the duodenum and explore the posterior peritoneum minutely. The operative procedure of choice depends on the general condition of the patient and the site and severity of the wound.
