The boy's bicycle hit an obstacle, causing its handle to impact his abdominal region. Urgent ultrasonography (FAST) showed echogenic free fluid in the pelvis extending upwards into Morison's pouch and intravesical echogenic content. Contrast-enhanced CT depicted hemoperitoneum and pneumobilia with periportal free gas sign, indicating upper GI tract hollow viscus injury.
The on-call surgical team performed laparotomy and confirmed duodenal injury. However, other organs, including the pancreas, appeared intact.