Isolated blunt duodenal trauma: Delayed diagnosis and favorable outcome with "quadruple tube" decompression

Stefano Crippa, Massimo Falconi, Rossella Bettini, Giuliano Barugola, Silvia Germenia, Roberto Salvia, Paolo Pederzoli

Research output: Contribution to journalArticlepeer-review


Context: Isolated blunt duodenal injury is a rare finding associated with high morbidity and significant mortality. The early identification of a duodenal injury is usually difficult, considering the anatomical location of the duodenum and lack of peritoneal signs and diagnostic delay is part of the clinical picture in most cases. Case report: A 43-year-old man was admitted to our hospital after a motor vehicle collision. At admission he underwent emergency surgery because of lower extremities fractures. Twelve hours later he started to complain an increasing abdominal pain; blood tests showed serum amylase up to 180 U/L and a CT scan demonstrated a perforation of the third duodenal portion. At laparotomy a Grade III injury of the duodenum was evident. The laceration was sutured and a "quadruple-tube" decompression was performed. The postoperative course was uneventful. One year after surgery he is well without any long-term complication. Conclusion: A high degree of suspicion is necessary for early diagnosis of blunt duodenal trauma and CT scan should be performed in case of all significant epigastric trauma. In most cases primary direct repair of duodenal wounds can be safely achieved and duodenal decompression via triple or quadriple tube technique is required to decrease the risk of duodenal fistula.

Original languageEnglish
Pages (from-to)617-620
Number of pages4
JournalJournal of the Pancreas
Issue number5
Publication statusPublished - Sep 2007


  • Decompression
  • Intestinal fistula
  • Sepsis
  • Surgery
  • Wounds and injuries

ASJC Scopus subject areas

  • Endocrinology
  • Gastroenterology


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