Case Report

Blunt abdominal trauma with duodenal dissection: A case report

Basile Essola*, Jean Baptiste Boumsong Batamag, Jean Paul Engbang, Dominique Djomo, Esdras Ngaroua, Jacques Landenne and Jean Gustave Tsiagadigui

Published: 28 July, 2021 | Volume 5 - Issue 2 | Pages: 023-026

We describe a new case of duodenal wound with complete transection in a 22-year-old patient following a motorcycle accident. He presented to the emergency room of the rural Regional Hospital of Edéa in Cameroon with a clinical picture of acute abdomen and post-trauma hemodynamic instability. A peritoneal puncture brought back an incoagulable blood. An exploratory laparotomy revealed a large hemoperitoneum mixed with food debris. A tear of the omentum and transverse mesocolon and a complete section of the third duodenum at the beginning of its free portion were observed. The surgeon performed emergency closure of both duodenal stumps and performed an isoperistaltic lateral gastrojejunal bypass. A transfer to a specialized center for a more anatomical continuity was considered, but the imminence of a humanitarian mission in the hospital prompted the surgeon to seize the opportunity of this mission for the reoperation. This surgical revision was performed on the fifth postoperative day. A resection of the distal duodenal stump and the adjacent jejunal segment including the anastomosis was performed. Continuity was restored by a mechanical duodenal-jejunal anastomosis. The patient was discharged on the 18th postoperative day. This type of lesion is difficult to manage in an emergency situation in a structure with limited technical resources. Unfortunately, surgeons treating polytraumatized civilians are encountering an increasing number of blunt duodenal wounds requiring laborious management.

Read Full Article HTML DOI: 10.29328/journal.acr.1001051 Cite this Article Read Full Article PDF


Duodenal wound-blunt trauma; Duodeno-jejunal anastomosis; Edéa Regional Hospital


  1. Hildebrands Jahresber. Meerwein. Herczel. 1896; 691.
  2. Corley RD, Norcross WJ, Shoemaker WC. Traumatic Injuries to the Duodenum: A Report of 98 Patients. Ann Ann Surg. 1975; 181: 92–98. PubMed: https://pubmed.ncbi.nlm.nih.gov/1119875/
  3. Burrus GR, Howell JF, Jordan GL Jr. Traumatic Duodenal Injuries. An Analysis of 86 Cases. J Trauma. 1961; 1: 96-104. PubMed: https://pubmed.ncbi.nlm.nih.gov/13689228/
  4. Cleveland HC, Waddell WR. Retroperitoneal Rupture of the Duodenum Due to Nonpenetrating Trauma. Surg Clin North Am. 1963; 43: 413. PubMed: https://pubmed.ncbi.nlm.nih.gov/14021722/
  5. Hanley JA. Retroperitoneal duodenal rupture. Br Med J. 1958; 1: 505-506. PubMed: https://pubmed.ncbi.nlm.nih.gov/13510710/
  6. Ivatury RR, Nassoura ZE, Simon RJ, Rodriguez A. Complex duodenal injuries. Surg Clin North Am. 1996; 76: 797-812. PubMed: https://pubmed.ncbi.nlm.nih.gov/8782474/
  7. Degiannis E, Boffard K. Duodenal injuries. Bri J Surg. 2000; 87: 1473-1479. PubMed: https://pubmed.ncbi.nlm.nih.gov/11091233/
  8. Levison MA, et al. Duodenal trauma: Experience of the trauma center. J Trauma. 1996; 40: 1037-1046.
  9. Kunin JR, Korobkin M, Ellis JH, Francis IR, Kane NM, et al. Duodenal injuries caused by blunt abdominal trauma: Value of CT in differentiating perforation from hematoma. AJR Am J Roentgenol. 1993; 160: 1221‑ PubMed: https://pubmed.ncbi.nlm.nih.gov/8498221/
  10. Timaran CH, Daley BJ, Enderson BL. Role of duodenography in the diagnosis of blunt duodenal injuries. J Trauma. 2001; 51: 648‑ PubMed: https://pubmed.ncbi.nlm.nih.gov/11586153/
  11. Moore EE, Cogbill TH, Malangoni A, Jurkovich GS, Champion HR, et al. Organ Injury Scaling II: Pancreas, Duodenum, Small Bowel, Colon, and Rectum. J Trauma. 1990; 30: 1427– 1429. PubMed: https://pubmed.ncbi.nlm.nih.gov/2231822/
  12. Lin BC, Chen RJ, Fang JF, Hsu YP, Kao YC, et al. Management of blunt major pancreatic injury. J Trauma. 2004; 56: 774–778. PubMed: https://pubmed.ncbi.nlm.nih.gov/15187740/
  13. Bankar SS, Gosavi VS, Hamid M. Duodenal transection without pancreatic injury following blunt abdominal trauma. J Surg Tech Case Rep. 2014; 6: 67-69. PubMed: https://pubmed.ncbi.nlm.nih.gov/25598947/


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