title: Isolated duodenal rupture due to go-karting accidents--braking news.
abstract: BACKGROUND
  Isolated duodenal injury due to blunt abdominal trauma is extremely rare. We present a series of three such injuries due to go-karting accidents, which presented to our hospital over 5 months.
  
  
  METHODS
  Between October 2007 and February 2008, three cases of D3/D4 duodenal rupture presented to our hospital after go-karting accidents. Trauma occurred as a result of the steering wheel impacting on the abdomen. All patients presented similarly with symptoms of epigastric and right upper quadrant pain. In all cases, computed tomography scanning was highly suggestive of duodenal injury and, in particular, demonstrated presence of retroperitoneal air centred around the duodenum. Treatment required laparotomy and operative repair in all cases.
  
  
  CONCLUSIONS
  Duodenal injury presents insidiously due to its retroperitoneal position. A low threshold for investigating patients presenting with epigastric and right upper quadrant pain should be adopted along with active clinical vigilance to exclude serious and life-threatening trauma after go-karting accidents.
authors.affiliation: Department of Surgery, Queen Elizabeth Hospital NHS Trust, London, UK.
authors.forename: Milan
authors.initials: M
authors.lastname: Thomas
authors.forename: Narendra Nath
authors.initials: NN
authors.lastname: Basu
authors.forename: Manpreet Singh
authors.initials: MS
authors.lastname: Gulati
authors.forename: Ruth
authors.initials: R
authors.lastname: Seager
authors.forename: Tayo
authors.initials: T
authors.lastname: Oke
authors.forename: Gabriel
authors.initials: G
authors.lastname: Constantinescu
authors.forename: Midhat
authors.initials: M
authors.lastname: Siddiqui