PMC7452464_01
Plain CT abdomen showing free fluid (arrow) in the Morrison's pouch.
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An ultrasound and a plain abdominal CT scan showed only free fluid in the abdomen (Fig. 1).
Bile staining (arrow) noted near the 2nd part of duodenum in the infracolic compartment.
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There was bile staining in the retroperitoneum near the second part of the duodenum (Fig. 2).
1 x 1 cm perforation in the anterolateral wall of 2nd part of duodenum with sheared off serosa.
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The duodenal wall around the perforation was friable, unhealthy with shearing of the serosal layer (Fig. 3).
Mobilisation of rectus muscle flap based on superior epigastric artery.
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The RAMF was secured using 3.0 vicryl sutures to the duodenum as shown in the Fig. 4, Fig. 5.