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A case of two traumatic penetrations of a duodenal diverticulum caused by a kick to the upper abdomen

INTRODUCTION AND IMPORTANCE: A duodenal diverticulum is a pseudodiverticulum that lacks a proper muscular layer. Cases of traumatic penetration or perforation of a duodenal diverticulum are relatively rare. CASE PRESENTATION: A 67-year-old woman was injured when her roommate kicked her in the upper...

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Autores principales: Shiraishi, Toshio, Wada, Hideo, Hashimoto, Shintaro, Katayama, Hiroki, Taba, Mitsuru, To, Kazuo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8449237/
https://www.ncbi.nlm.nih.gov/pubmed/34536768
http://dx.doi.org/10.1016/j.ijscr.2021.106388
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author Shiraishi, Toshio
Wada, Hideo
Hashimoto, Shintaro
Katayama, Hiroki
Taba, Mitsuru
To, Kazuo
author_facet Shiraishi, Toshio
Wada, Hideo
Hashimoto, Shintaro
Katayama, Hiroki
Taba, Mitsuru
To, Kazuo
author_sort Shiraishi, Toshio
collection PubMed
description INTRODUCTION AND IMPORTANCE: A duodenal diverticulum is a pseudodiverticulum that lacks a proper muscular layer. Cases of traumatic penetration or perforation of a duodenal diverticulum are relatively rare. CASE PRESENTATION: A 67-year-old woman was injured when her roommate kicked her in the upper abdomen, and was transferred to our hospital 6 h after the injury with upper abdominal pain and lethargy. Computed tomography revealed a duodenal diverticulum and retroperitoneal emphysematous changes and exudates. Peritonitis due to duodenal penetration was suspected and emergency laparotomy was performed. Intraoperative findings revealed two traumatic penetrations of the duodenal diverticulum. We resected the diverticulum with an automatic suture device and covered the resection site with omentum. Twenty-one days postoperatively, she was transferred to her original hospital with no complications following an uneventful postoperative course. CLINICAL DISCUSSION: Most causes of penetration or perforation of the duodenal diverticulum are diverticulitis, and few reports have described penetration or perforation of duodenal diverticulum due to trauma. Our case was extremely rare that caused by a kick to the upper abdomen and resulted in two penetrations of a duodenal diverticulum although factors contributing to the multiple penetrations were considered. CONCLUSION: Penetration or perforation of a duodenal diverticulum occasionally results in a rapid deterioration to a severe state. Comprehensive judgement of the general condition and laboratory findings and selection of an appropriate treatment policy is important.
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spelling pubmed-84492372021-09-24 A case of two traumatic penetrations of a duodenal diverticulum caused by a kick to the upper abdomen Shiraishi, Toshio Wada, Hideo Hashimoto, Shintaro Katayama, Hiroki Taba, Mitsuru To, Kazuo Int J Surg Case Rep Case Report INTRODUCTION AND IMPORTANCE: A duodenal diverticulum is a pseudodiverticulum that lacks a proper muscular layer. Cases of traumatic penetration or perforation of a duodenal diverticulum are relatively rare. CASE PRESENTATION: A 67-year-old woman was injured when her roommate kicked her in the upper abdomen, and was transferred to our hospital 6 h after the injury with upper abdominal pain and lethargy. Computed tomography revealed a duodenal diverticulum and retroperitoneal emphysematous changes and exudates. Peritonitis due to duodenal penetration was suspected and emergency laparotomy was performed. Intraoperative findings revealed two traumatic penetrations of the duodenal diverticulum. We resected the diverticulum with an automatic suture device and covered the resection site with omentum. Twenty-one days postoperatively, she was transferred to her original hospital with no complications following an uneventful postoperative course. CLINICAL DISCUSSION: Most causes of penetration or perforation of the duodenal diverticulum are diverticulitis, and few reports have described penetration or perforation of duodenal diverticulum due to trauma. Our case was extremely rare that caused by a kick to the upper abdomen and resulted in two penetrations of a duodenal diverticulum although factors contributing to the multiple penetrations were considered. CONCLUSION: Penetration or perforation of a duodenal diverticulum occasionally results in a rapid deterioration to a severe state. Comprehensive judgement of the general condition and laboratory findings and selection of an appropriate treatment policy is important. Elsevier 2021-09-06 /pmc/articles/PMC8449237/ /pubmed/34536768 http://dx.doi.org/10.1016/j.ijscr.2021.106388 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Shiraishi, Toshio
Wada, Hideo
Hashimoto, Shintaro
Katayama, Hiroki
Taba, Mitsuru
To, Kazuo
A case of two traumatic penetrations of a duodenal diverticulum caused by a kick to the upper abdomen
title A case of two traumatic penetrations of a duodenal diverticulum caused by a kick to the upper abdomen
title_full A case of two traumatic penetrations of a duodenal diverticulum caused by a kick to the upper abdomen
title_fullStr A case of two traumatic penetrations of a duodenal diverticulum caused by a kick to the upper abdomen
title_full_unstemmed A case of two traumatic penetrations of a duodenal diverticulum caused by a kick to the upper abdomen
title_short A case of two traumatic penetrations of a duodenal diverticulum caused by a kick to the upper abdomen
title_sort case of two traumatic penetrations of a duodenal diverticulum caused by a kick to the upper abdomen
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8449237/
https://www.ncbi.nlm.nih.gov/pubmed/34536768
http://dx.doi.org/10.1016/j.ijscr.2021.106388
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