• ROKKAM MEHER KRISHNA PRIYANKA
• SANKET MANDLIK
• GOKUL JORWEKAR

Introduction: Gastrointestinal perforation is observed in 4-9% of patients presenting with blunt abdominal trauma, with most cases resulting from motor vehicle accidents. However, bicycle handlebar injuries contribute to 14-20% of these cases. The rarity and subtle clinical presentation of pyloro - duodenal perforation frequently delays diagnosis and intervention. Limited data exists on managing pyloro - duodenal junction perforation, as it is an uncommon injury from blunt abdominal trauma, particularly due to handlebar impact. This case report underscores the challenges of managing an isolated pyloro - duodenal perforation in a resource-limited rural setting. Objective: To explore the management of a giant isolated Pyloro - Duodenal junction perforation following blunt abdominal trauma in a tertiary rural hospital. Case Presentation: A 13-year-old tribal girl was brought to the emergency department on 15/07/24 at 3:28 PM with complaints of abdominal pain, nausea, and vomiting following a blunt abdominal trauma from a bicycle handlebar the previous evening (14/07/24). - Vitals: Pulse 140 bpm, BP - non-recordable (hypovolemic shock suspected), SpO₂ 98% on 5L O₂, respiratory rate – 26 cycles per minute - Abdomen: Distended with diffuse tenderness, guarding, rigidity, and obliteration of liver dullness - X-ray: Air under the diaphragm on the right side, suggestive of hollow viscous perforation Fluid resuscitation was done. An emergency exploratory laparotomy revealed a perforation near the pyloro - duodenal junction, measuring approximately 6x3 cm. Modified Jone’s repair with Retrograde Tube Duodenostomy with Feeding Jejunostomy was performed. Clinical Lesson Learnt: An abdominal trauma from a bicycle handlebar resulted in a rare and giant pyloro - duodenal junction perforation. Despite the challenges of limited resources in a rural setting, the condition was successfully managed with timely surgical intervention.

pediatric, handle bar injury, duodenal perforation, modified jones repair,

"A Traumatic Giant Isolated Pyloro-Duodenal Junction Perforation in an Adolescent Girl – A Case Report", International Journal of Emerging Technologies and Innovative Research (www.jetir.org), ISSN:2349-5162, Vol.12, Issue 2, page no.g35-g40, February-2025, Available :http://www.jetir.org/papers/JETIR2502605.pdf

"A Traumatic Giant Isolated Pyloro-Duodenal Junction Perforation in an Adolescent Girl – A Case Report", International Journal of Emerging Technologies and Innovative Research (www.jetir.org | UGC and issn Approved), ISSN:2349-5162, Vol.12, Issue 2, page no. ppg35-g40, February-2025, Available at : http://www.jetir.org/papers/JETIR2502605.pdf