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Duodenal injuries.

E Degiannis1, K Boffard

  • 1Department of Surgery, Medical School, University of the Witwatersrand, Johannesburg, Republic of South Africa.

The British Journal of Surgery
|November 25, 2000
PubMed
Summary

Duodenal trauma diagnosis and management have advanced. While imaging aids diagnosis, surgery is definitive for suspected injuries, with most duodenal injuries treated by simple repair.

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Area of Science:

  • Trauma Surgery
  • Gastrointestinal Surgery

Background:

  • Increasing incidence of duodenal trauma globally due to road traffic accidents and firearm use.
  • Duodenal trauma presents a significant challenge in emergency medicine and surgical practice.

Purpose of the Study:

  • To review the literature on duodenal trauma diagnosis and management from 1970-1999.
  • To outline current diagnostic and therapeutic strategies for duodenal injuries.

Main Methods:

  • Comprehensive review of English language literature on duodenal trauma.
  • Analysis of diagnostic modalities including radiological studies and computed tomography.
  • Evaluation of surgical management techniques for various duodenal injury severities.

Main Results:

  • Radiological studies and CT scans can aid in diagnosing blunt duodenal trauma.
  • Exploratory laparotomy is the definitive diagnostic test for high-suspicion injuries with equivocal imaging.
  • Simple repair is effective for most duodenal injuries; complex cases require advanced techniques.

Conclusions:

  • High-risk duodenal injuries necessitate duodenal diversion to prevent suture line dehiscence.
  • Pancreaticoduodenectomy is reserved for unreconstructable injuries.
  • 'Damage control' principles should guide initial management before definitive repair.

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