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Arch Surg. 2005;140:1006.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Answer: Traumatic Intramuscular Cyst of the Duodenum

The patient underwent exploratory laparotomy with segmental resection of the third and fourth portions of the duodenum, which demonstrated an isolated cystic mass with evidence of hemorrhage distal to the descending (second) portion of the duodenum. The patient subsequently underwent duodenojejunostomy.

Pathological examination showed an intramuscular cystlike cavity lined with granulation tissue and 1 lymph node with no significant pathological abnormality. The muscularis propria of the duodenum was dissected by the cystic space, which contained features of hemorrhage; no epithelial lining was present. The findings were compatible with prior muscular hemorrhage consistent with blunt physical trauma.

The insidious nature of blunt duodenal injuries makes initial diagnosis difficult, potentially compromising patient care.¹ The predominantly retroperitoneal location of the duodenum offers protection but contributes to the difficulty in identifying injury, especially in individuals without abdominal complaints or with distracting injuries. Although an abdominal computed tomographic scan with both oral and intravenous contrast . . . [Full Text of this Article]

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Arch Surg. 2005;140(10):1005.
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