Diagnosis and Classification of Duodenal Injuries in Emergency Radiology

Duodenal injuries from Sun YaiCheng

Diagnosis and Classification of Pancreatic and Duodenal Injuries in Emergency Radiology
RadioGraphics 2008; 28:1591–1601

In duodenal injuries, differentiation between a contusion of the duodenal wall or mural hematoma and a duodenal perforation is vital. 

• Duodenal contusion is suspected with edema or hematoma of the duodenal wall, intramural gas accumulations, and focal duodenal wall thickening ( >4 mm) as findings of small bowel injury.
• Duodenal perforation is suspected if there is a retroperitoneal collection of contrast medium, extraluminal gas, or a lack of continuity of the duodenal wall.
• Fluid or a hematoma in the retroperitoneum, stranding of retroperitoneal fatty tissue, or pancreatic transection can be present in both conditions