A slow onset of abdominal pain, fever, and nausea/vomiting after trauma is most consistent with injury to which hollow organ?

• A. Gastric perforation
• B. Duodenal injury
• C. Renal contusion
• D. Splenic laceration

Answer: (B)

In blunt abdominal trauma, injuries to hollow organs can present with delayed symptoms, especially when the organ lies retroperitoneally. The duodenum is mostly retroperitoneal, so when it’s injured, contents can leak into the retroperitoneal space rather than causing immediate, widespread peritoneal irritation. This can lead to a gradual onset of abdominal pain with fever and nausea/vomiting as inflammation and irritation develop over several hours.

In contrast, injuries to solid organs or to other hollow organs often produce more immediate signs: splenic laceration or renal contusion tend to present with sudden pain, signs of bleeding, or hematuria rather than a slow fever-driven course; gastric perforation typically causes rapid, severe peritoneal signs due to leakage of gastric contents into the peritoneal cavity. Thus, the delayed fever and abdominal symptoms after trauma align best with a duodenal injury.