Price Chloe, Kim Kyle, Pardhan Amyn
Department of General Surgery Bunbury Regional Hospital, Australia.
Trauma Case Rep. 2025 Jul 12;58:101195. doi: 10.1016/j.tcr.2025.101195. eCollection 2025 Aug.
Acute duodenal injuries are notably rare and present significant challenges in clinical detection. The advent of bariatric surgery has introduced further complexity, altering the anatomy of the upper gastrointestinal tract and potentially masking typical presentations of duodenal injuries. We present the case of a 58-year-old woman with a history of omega loop bypass, who presumably suffered a traumatic duodenal perforation following a fall from a height of 2 m. The perforation was initially missed due to the absence of free air in the retroperitoneum, likely influenced by the altered anatomy post-bypass surgery. This case highlights the difficulty in timely diagnosis of duodenal injuries and the importance of heightened vigilance in post-bariatric surgery patients who've sustained blunt force trauma.
急性十二指肠损伤极为罕见，在临床检测中面临重大挑战。减肥手术的出现带来了更多复杂性，改变了上消化道的解剖结构，并可能掩盖十二指肠损伤的典型表现。我们报告一例58岁女性病例，该患者有omega袢旁路手术史，据推测在从2米高处跌落之后发生了外伤性十二指肠穿孔。由于腹膜后没有游离气体，穿孔最初被漏诊，这可能受到旁路手术后解剖结构改变的影响。该病例凸显了十二指肠损伤及时诊断的困难，以及对遭受钝性外力创伤的减肥手术后患者提高警惕的重要性。
