Abstract RETROPERITONEAL rupture of the duodenum due to blunt abdominal trauma unassociated with injury to any of the intraperitoneal viscera is uncommon. This, and the fact that it is easy to miss a perforation in the retroperitoneal portion of the duodenum, might explain the high mortality in such patients. There is ample truth in Cocke's1 statement that such a lesion is a difficult one to handle and a dangerous one to mishandle. Two patients with such an injury have been recently treated at the Christian Medical College Hospital, Ludhiana, Punjab, India, and it seems worthwhile to present these cases and review the subject. Report of Cases Case 1 (CMCH-285865). —A 27-year-old woman was admitted with a 20-hour history of generalized abdominal pain, recurrent vomiting, and absolute constipation following blunt trauma to her right upper part of the abdomen sustained when she intervened in a fight between her husband and others. References 1. Cocke, W.M., Jr., and Meyer, K.K.: Retroperitoneal Duodenal Rupture: Proposed Mechanism, Review of Literature and Report of a Case , Amer J Surg 108:834-839 ( (Dec) ) 1964.Crossref 2. Johnson, M.L.: Traumatic Retroperitoneal Rupture of the Duodenum , Arch Surg 48:372-380 ( (May) ) 1944.Crossref 3. Cohn, I., Jr.; Hawthorne, H.R.; and Frobese, A.S.: Retroperitoneal Rupture of the Duodenum in Nonpenetrating Abdominal Trauma , Amer J Surg 84:293-301 ( (Sept) ) 1952.Crossref 4. Geoghegan, T., and Brush, B.E.: The Mechanism of Intestinal Perforation from Nonpenetrating Abdominal Trauma , Arch Surg 73:455-464 ( (Sept) ) 1956.Crossref 5. Adnopoz, A., and Fortuna, A.B.: Retroperitoneal Rupture of the Duodenum , Arch Surg 83:937-942 ( (Dec) ) 1961.Crossref 6. Simpson, J.A.: Traumatic Retroperitoneal Rupture of the Duodenum , Brit J Surg 37:483-485 ( (April) ) 1950.Crossref 7. Sarnoff, J., and Oremland, B.H.: Traumatic Rupture of the Duodenum , Surgery 14:272-277 ( (Aug) ) 1943. 8. Hanley, J.A.: Retroperitoneal Duodenal Rupture , Brit Med J 1:505-506 ( (March 1) ) 1958.Crossref 9. Stransky, J.J.: Retroperitoneal Rupture of the Duodenum Due to Nonpenetrating Abdominal Trauma , Surgery 35:928-936 ( (June) ) 1954.
Archives of Surgery – American Medical Association
Published: Jun 1, 1968