{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T23:35:38Z","timestamp":1781825738972,"version":"3.54.5"},"reference-count":14,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,8,4]]},"abstract":"<jats:p>We report a case of late presenting duodenal perforation with common bile duct rupture secondary to blunt handlebar trauma in an 11-year-old boy. The patient presented with upper abdominal wall ecchymosis, pain and vomiting. He was discharged after 24\u2009hours with resolving symptoms. However, the boy presented 2\u2009days later febrile with signs of peritonitis. CT indicated duodenal perforation, which was confirmed during laparotomy where common bile duct rupture was also demonstrated. Primary repair of the duodenum was undertaken. Here, decompression was achieved with a nasogastric tube proximal to the injury and T-tube duodenostomy distally. Common bile duct repair was achieved over a biliary stent. This case represents a rare subset of duodenal injury for which there is a paucity of evidence for optimal surgical management, particularly in the paediatric setting. This operative plan will guide surgeons and junior doctors in managing complicated cases like this in future.<\/jats:p>","DOI":"10.1136\/bcr-2018-225221","type":"journal-article","created":{"date-parts":[[2018,8,29]],"date-time":"2018-08-29T15:55:39Z","timestamp":1535558139000},"page":"bcr-2018-225221","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Paediatric duodenal injury complicated by common bile duct rupture due to blunt trauma: a multispecialist approach"],"prefix":"10.1136","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9020-0916","authenticated-orcid":false,"given":"Graham","family":"Garside","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahid","family":"Mukhtar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandrasen","family":"Sinha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,8,29]]},"reference":[{"key":"2025042706051611000_2018.aug29_1.bcr-2018-225221.1","unstructured":"The Royal College of Radiologists. Paediatric Trauma Protocols [Internet]: The Royal College of Radiologists, 2014. https:\/\/www.rcr.ac.uk\/publication\/paediatric-trauma-protocols."},{"key":"2025042706051611000_2018.aug29_1.bcr-2018-225221.2","doi-asserted-by":"publisher","DOI":"10.1016\/S1072-7515(98)00205-1"},{"key":"2025042706051611000_2018.aug29_1.bcr-2018-225221.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(99)90379-2"},{"key":"2025042706051611000_2018.aug29_1.bcr-2018-225221.4","doi-asserted-by":"publisher","DOI":"10.1080\/110241599750007315"},{"key":"2025042706051611000_2018.aug29_1.bcr-2018-225221.5","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199606000-00035"},{"key":"2025042706051611000_2018.aug29_1.bcr-2018-225221.6","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/S0039-6109(16)46589-8","article-title":"Organ injury scaling","volume":"75","author":"Moore","year":"1995","journal-title":"Surg Clin North Am"},{"key":"2025042706051611000_2018.aug29_1.bcr-2018-225221.7","doi-asserted-by":"crossref","first-page":"bcr-2016-215251","DOI":"10.1136\/bcr-2016-215251","article-title":"Isolated duodenal rupture: primary repair without diversion; is it safe? Review of literature","volume":"2017","author":"Telfah","year":"2017","journal-title":"BMJ Case Rep"},{"key":"2025042706051611000_2018.aug29_1.bcr-2018-225221.8","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2015-213330"},{"key":"2025042706051611000_2018.aug29_1.bcr-2018-225221.9","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1007\/s00068-010-0055-4","article-title":"Management of isolated duodenal rupture due to blunt abdominal trauma: case series and literature review","volume":"36","author":"Celik","year":"2010","journal-title":"Eur J Trauma Emerg Surg"},{"key":"2025042706051611000_2018.aug29_1.bcr-2018-225221.10","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-007-3529-1"},{"key":"2025042706051611000_2018.aug29_1.bcr-2018-225221.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2004.02.032"},{"key":"2025042706051611000_2018.aug29_1.bcr-2018-225221.12","doi-asserted-by":"publisher","DOI":"10.1016\/S0720-048X(03)00145-1"},{"key":"2025042706051611000_2018.aug29_1.bcr-2018-225221.13","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1053\/otgn.2000.16375","article-title":"Duodenal primary repair, diversion, and exclusion","volume":"2","author":"Britt","year":"2000","journal-title":"Oper Tech Gen Surg"},{"key":"2025042706051611000_2018.aug29_1.bcr-2018-225221.14","unstructured":"Boone D , Peitzman A , Al E . Abdominal Injury- Duodenum and pancreas. In: Peitzman A , Rhodes M , Schwab S , eds. The trauma manual. Philadephia, Pennsylvania: Lippincott-Raven, 1998:242\u20137."}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-225221","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T13:05:26Z","timestamp":1745759126000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-225221"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8,29]]},"references-count":14,"alternative-id":["10.1136\/bcr-2018-225221"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-225221","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8,29]]}}}