Presentation
Blunt abdominal injury while playing soccer. Pain right upper quadrant.
Patient Data
Free fluid around the lateral margin of the duodenum (D2) extending around the pole of the liver and the right paracolic gutter. Free peritoneal fluid in the context of blunt abdominal trauma in this distribution in a child is suspicious for duodenal perforation.
Periportal free fluid.
On close inspection of the coronals, a defect in the sidewall of the duodenum is visualized (key image).
Contrast leak from D2 laterally confirmed suspected duodenal perforation.
Case Discussion
Duodenal perforation is not uncommon in blunt injury in children and young people. If suspected on CT, a contrast examination with water soluble contrast media can confirm the diagnosis.
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