PMC4964077_01
Axial section of contrast-enhanced computerized tomography (CECT) abdomen at the level of D2 (second part of the duodenum, arrow) showing discontinuity in the lateral wall of duodenum, extravasation of negative contrast with intraluminal communication, and few air pockets (brace)
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Fig1
A contrast-enhanced computerized tomography (CECT) of the abdomen was done, which revealed free fluid of high density in the peritoneal cavity around the hepato-renal pouch and localized free air in retroperitoneum around second part of duodenum, which was communicating with the lumen (Fig. 1).
a Intra-operative image showing the perforation (arrow) in relation to stomach (S), first part of the duodenum (D1) and second part of duodenum (D2). b Same region after repair is complete and buttressed by an omental patch (arrow head)
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Fig2
After kocherization, a 2 x 2 cm perforation was seen on the lateral wall of the second part of duodenum (Fig. 2a). A pedicled omental patch was added (Fig. 2b).