Duodenal rupture following trauma in a child

We present a case of delayed presentation of a traumatic duodenal rupture in a 15-year-old boy. He presented 12 hours after falling six feet and sustaining blunt trauma to his anterior abdominal wall. On arrival in the Emergency Department he was shocked and peritonitic. After initial resuscitation he was stable and transferred to computed tomography where free retroperitoneal air and duodenal rupture was found. He was transferred to theatre where he underwent laparotomy and successful repair of the rupture. He made an uneventful recovery and was discharged nine days later. Duodenal rupture is a rare but serious complication of blunt abdominal trauma. Diagnosis is difficult but missed diagnosis and delayed presentation is associated with high morbidity and mortality. A high index for suspicion must be kept when dealing with blunt abdominal trauma to ensure this is not missed.