PMC9910818_01
Radiograph of the abdomen in the standing position showing air under the right hemidiaphragm, as indicated by the arrow.
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FIG1
X-ray of the abdomen in the standing position showed air under the right hemidiaphragm, suggestive of hollow viscus perforation (Figure 1).
Intraoperative image showing the perforation of the fourth part of the duodenum, as depicted by the arrow.
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PMC9910818_01_cureus-0015-00000033571-i02.jpg
FIG2
A small (1.2 cm x 1.3 cm) single perforation was found on the anterior wall of the fourth part of the duodenum (Figure 2).
Intraoperative image showing the closure of the defect using the omental patch, that is, modified Graham patch repair, as depicted by the arrow.
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PMC9910818_01_cureus-0015-00000033571-i03.jpg
FIG3
The perforation was repaired with a Graham patch omentopexy (Figure 3), and a nasojejunal tube was placed beyond the site of the perforation. 