Isolated perforation of a duodenal diverticulum following blunt abdominal trauma

Abstract

Only 10% of duodenal diverticula are symptomatic. We present the case of a man who fell from a height of 6 ft, landing on his abdomen and presenting 4 h later with severe back pain and a rigid abdomen. At laparotomy, a perforated retroperitoneal duodenal diverticulum was found and repaired with an omental patch. No other injury was noted. Not only is this perforation unusual, but the absence of other injuries sustained during this minor blunt trauma makes this case unique. This case highlights the need for a high index of suspicion when managing patients with back or abdominal pain following minor trauma.

Keywords: Duodenal diverticulum; blunt trauma; perforation.

Figure 1

Computed tomography, axial image, demonstrating a retroperitoneal fluid- and air-filled collection posterior to the second part of the duodenum. (P = pancreatic head, S = splenic vein, I = inferior vena cava, C = air- and fluid-filled collection, D = duodenum)