Duodenal wall necrosis with the perforation into retroperitoneal space in the course of perinephric abscess. The case description and the management method

Abstract

Duodenal perforation is an infrequent and severe acute surgical condition which commonly follows the complications resulting from endoscopic and laparoscopic procedures. Small size of damages arisen in this mechanism and an early diagnosis allows for their effective primary management. The most difficult surgical challenge is an effective management of retroperitoneal duodenal part perforation together with coexisting pathological changes of its wall. In this work we present the case of duodenal necrosis with excessive necrosis of the fragment of its wall due to the course of perinephric abscess and an effective method of defect management on the isolated free small enteral loop in association with gastric-duodenal passage exclusion.