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Management of duodenal injuries in children

J N Clendenon1, R L Meyers, M L Nance

  • 1Primary Children's Medical Center, Salt Lake City, UT, USA.

Journal of Pediatric Surgery
|June 9, 2004
PubMed

Insights

Pediatric duodenal injuries are mostly blunt trauma with low mortality. Primary surgical repair is often feasible for these injuries in children.

Area of Science:

  • Pediatric surgery
  • Trauma surgery
  • Gastrointestinal surgery

Background:

  • The natural history and management of pediatric duodenal injuries require further elucidation.
  • Understanding injury mechanisms and outcomes is crucial for improving patient care.

Purpose of the Study:

  • To review injury mechanisms, surgical management strategies, and outcomes of pediatric duodenal injuries.
  • To analyze factors influencing complications and hospitalization in pediatric duodenal trauma.

Main Methods:

  • Retrospective chart review of pediatric patients (<18 years) treated for duodenal injuries over a 10-year period.
  • Inclusion of data from two major pediatric trauma centers.
  • Classification of injuries using the Organ Injury Scale for the Duodenum.

Main Results:

  • Forty-two pediatric duodenal injuries were identified, predominantly blunt (33) versus penetrating (9).
  • Operative management included primary repair (18), duodenal resection with gastrojejunostomy (4), and pyloric exclusion (2); 94% of duodenal hematomas were managed nonoperatively.
  • Delayed diagnosis or intervention (>24 hours) correlated with higher complication rates (43% vs. 29%) and longer hospitalizations (32 vs. 20 days).

Conclusions:

  • Pediatric duodenal injuries are most commonly caused by blunt trauma and are associated with a low mortality rate.
  • Primary repair is frequently a viable surgical option for pediatric duodenal injuries.
  • Timely diagnosis and intervention are critical to minimize complications and reduce hospitalization duration.
Abstract

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