Neglected, Traumatic Duodenal Rupture - Case Report

A case of neglected, double-site, post-traumatic duodenal rupture, which was overlooked at the emergency laparotomy due to intra-abdominal bleeding is presented. For nine days the excessive laceration remained asymptomatic, probably because of visceral adhesions. Both tears of the duodenum were eventually repaired, but symptoms and signs of high mechanical obstruction had developed afterwards, requiring repeated surgery (gastric decompression). Endoscopy performed 2 weeks after duodenal repair showed both, repair site and gastro-jejunal anastomosis permeable. All symptoms quickly with-drawn and the patient recovered. Possible causes of the atypical clinical course in this case were discussed.