A 19-year-old girl presented to the Emergency Department at 1 am after having a football kicked from a distance of 5-10 m into her abdomen 7 h previously whilst watching a game. She complained of worsening diffuse abdominal pain and vomiting. Her observations were stable; however, on examination, her abdomen was diffusely tender and there was evidence of generalized peritonism. She had a white cell count of 18.8 x 109/l, but the rest of her blood tests, including amylase, was normal. Her chest radiograph did not show any evidence of free air under the diaphragm. A computed tomographic (CT) scan of her abdomen and pelvis was arranged, which showed abnormal areas of low attenuation and multiple pockets of air in the right flank, surrounding the right kidney and in the right sub-hepatic space, consistent with a perforation of either the ascending colon or the duodenum (Fig. 1). A laparotomy was performed and a 0.5 cm perforation was seen in the antero-lateral border of the duodenum at the junction of the first and second parts of the duodenum following kocherization. The perforation was oversewn and repaired with an omental patch. She recovered well from the operation and was discharged 4 days later.