[Duodeno-pancreatic trauma. About 14 cases]

Managing duodeno-pancreatic trauma remains a challenge in trauma surgery. While prior research has identified traffic accidents as a leading cause of such injuries, the specific clinical patterns and diagnostic challenges remain unclear. Existing literature has not fully addressed the variability in presentation and the role of imaging in early detection. This gap motivated the need for a detailed analysis of case series to refine clinical strategies. The retrospective nature of many studies limits the ability to assess real-time diagnostic and therapeutic decisions. No prior work had resolved the high complication rates associated with these injuries. The lack of standardized protocols for both diagnosis and treatment contributes to inconsistent outcomes. This uncertainty drives the need for a comprehensive review of clinical practices. Understanding the frequency of associated injuries is essential for improving trauma care.

The study aimed to analyze a 12-year series of 14 cases of duodeno-pancreatic trauma to improve clinical management. The researchers focused on demographic patterns, injury etiology, and diagnostic approaches. They sought to clarify the role of imaging in early detection and the effectiveness of surgical versus medical interventions. The motivation was to reduce complications and mortality by identifying best practices. The study also aimed to highlight the frequency of associated injuries and their impact on outcomes. The researchers wanted to determine the most common clinical presentations, such as urgent surgical abdomen or delayed complications. They examined the influence of trauma type—closed versus penetrating—on treatment decisions. The ultimate goal was to provide evidence-based recommendations for managing these complex injuries.

The researchers conducted a retrospective, analytical, and descriptive study using a 12-year case series. They reviewed medical records of 14 patients with duodeno-pancreatic trauma. Demographic data, injury mechanisms, and associated lesions were extracted. Diagnostic methods, including ultrasound and computed tomography, were analyzed for accuracy. Surgical and medical treatments were categorized as conservative or radical. Complication rates and mortality were recorded during follow-up. The study focused on the timing of trauma presentation—urgent, secondary, or delayed. The researchers compared outcomes based on diagnostic tools and treatment approaches. They also assessed the impact of trauma type on clinical decisions.

The study included 14 patients, with 12 men and 2 women, averaging 24.4 years of age. Traffic accidents caused 7 injuries (50%), and 13 cases were closed traumas (92%). Ten patients had pancreatic injuries, 2 had duodenal injuries, and 2 had combined injuries. Thirteen patients (92%) had associated lesions. Nine patients presented with urgent surgical abdomen, while 3 had delayed complications. Abdominal ultrasound diagnosed only one case, whereas computed tomography identified all four cases it was used for. One patient received medical treatment for post-traumatic acute pancreatitis. Thirteen patients underwent surgery: 7 conservative and 6 radical. Eleven patients (78%) had complications, and the mortality rate was 7.1%.

The study highlights the challenges in diagnosing and managing duodeno-pancreatic trauma. Traffic accidents are a major cause, and most injuries are closed. The high rate of associated lesions suggests the need for thorough trauma assessments. Computed tomography appears more effective than ultrasound in diagnosing these injuries. Medical treatment was limited to one case, indicating the predominance of surgical interventions. The high complication rate underscores the complexity of these injuries. The mortality rate of 7.1% reflects the severity of the condition. The researchers propose that early diagnosis and appropriate surgical planning may improve outcomes. Their findings suggest the value of a structured approach to trauma management in this patient group.