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[Injuries of the duodenum]
Vestnik Khirurgii Imeni I. I. Grekova
|February 15, 2000
Summary
Surgical repair of duodenal injuries, primarily through suturing, offers the best outcomes. Advanced techniques like exclusion may aid in complex cases, reducing mortality from trauma.
Area of Science:
- Gastroenterology
- Trauma Surgery
- Surgical Outcomes
Background:
- Duodenal injuries present significant challenges in trauma care.
- Understanding causes and outcomes is crucial for improving patient survival.
Purpose of the Study:
- To analyze causes, complications, and mortality associated with duodenal injuries.
- To evaluate the effectiveness of different surgical interventions for duodenal trauma.
Main Methods:
- Retrospective case series analysis of 94 patients with duodenal injuries over 10 years.
- Categorization of injuries by cause (stabbing, gunshot, blunt trauma, iatrogenic) and type (isolated vs. combined).
- Review of surgical procedures and patient outcomes, including mortality and complications.
Main Results:
- Traumatic perforations accounted for 89.4% of duodenal injuries, with a 31% mortality rate.
- Suturing was the most common repair (70 patients), followed by exclusion (6 patients) and resection (1 patient).
- Hemorrhage, combined injuries, and pyo-septic complications were major causes of death.
Conclusions:
- Suturing is effective for most incised or lacerated duodenal wounds.
- Duodenal exclusion can be beneficial for large wounds.
- Pancreatoduodenectomy is rarely indicated for duodenal trauma.