case_images: PMC9910818_01
case_images: Radiograph of the abdomen in the standing position showing air under the right hemidiaphragm, as indicated by the arrow.
case_images: cureus-0015-00000033571-i01.jpg
case_images: PMC9910818_01_cureus-0015-00000033571-i01.jpg
case_images: FIG1
case_images: X-ray of the abdomen in the standing position showed air under the right hemidiaphragm, suggestive of hollow viscus perforation (Figure 1).
case_images: Intraoperative image showing the perforation of the fourth part of the duodenum, as depicted by the arrow.
case_images: cureus-0015-00000033571-i02.jpg
case_images: PMC9910818_01_cureus-0015-00000033571-i02.jpg
case_images: FIG2
case_images: A small (1.2 cm x 1.3 cm) single perforation was found on the anterior wall of the fourth part of the duodenum (Figure 2).
case_images: Intraoperative image showing the closure of the defect using the omental patch, that is, modified Graham patch repair, as depicted by the arrow.
case_images: cureus-0015-00000033571-i03.jpg
case_images: PMC9910818_01_cureus-0015-00000033571-i03.jpg
case_images: FIG3
case_images: The perforation was repaired with a Graham patch omentopexy (Figure 3), and a nasojejunal tube was placed beyond the site of the perforation. 