Hemodynamic Collapse and Hidden Pathology: A Case of Perforated Duodenal Diverticulum Identified During Trauma Laparotomy

TL;DR

This paper describes a rare case of a life-threatening duodenal diverticulum perforation following a car accident, requiring emergency surgery.

Contribution

The novelty lies in presenting a rare clinical case of traumatic duodenal diverticulum perforation and its management in an acute trauma setting.

Findings

Blunt abdominal trauma can lead to perforation of a duodenal diverticulum, a rare and life-threatening condition.

Emergency laparotomy and stapled diverticulectomy were effective in treating the injury when preoperative imaging was not available.

Timely surgical intervention is crucial in managing such rare and challenging traumatic injuries.

Abstract

Duodenal diverticula are rare extraluminal sac-like protrusions of the duodenal wall. Perforation of the diverticula is a life-threatening but uncommon complication, particularly following blunt abdominal trauma. We present the case of an 82-year-old woman who sustained blunt abdominal trauma after being struck by a motor vehicle, resulting in perforation of a duodenal diverticulum. She was hemodynamically unstable on arrival, necessitating emergent exploratory laparotomy during which a stapled diverticulectomy was performed. This case highlights the rarity of traumatic perforation of duodenal diverticula and the challenges of diagnosing and managing such injuries in the acute setting. It also underscores the importance of flexible and timely surgical intervention, particularly when preoperative imaging is unavailable.

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