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TREATMENT OF DUODENAL INJURIES AND COMPLICATIONS AFTER SURGERY (CASE REPORTS).

Z Beriashvili1, M Gurgenidze1

  • 11Critical Care Medicine Institute, Tbilisi; Ivane Javakhishvili Tbilisi State University, Department of Surgery; 2The First University Clinic of Tbilisi State Medical University, Department of General Surgery, Tbilisi State Medical University, Department of Surgery № I, Georgia.

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This study presents two successful non-standard surgical treatments for complex duodenal injuries and fistulas, demonstrating effective management of severe gastrointestinal trauma. These case reports highlight adaptable surgical approaches for challenging duodenal damage.

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Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Trauma Surgery

Background:

  • Duodenal injuries, particularly those resulting in fistulas or retroperitoneal complications, present significant surgical challenges.
  • Standard treatment protocols may not always be applicable to complex duodenal trauma, necessitating tailored surgical strategies.

Observation:

  • Two cases of severe duodenal injury are presented: one gunshot wound with a resulting duodenal fistula and another traumatic injury to the retroperitoneal duodenum.
  • Initial surgical repair in both cases was followed by postoperative complications, including wound leakage and retroperitoneal phlegmon.

Findings:

  • A novel approach involving Roux-en-Y jejunal reconstruction and end-to-end anastomosis was successfully employed for a large duodenal fistula.
  • In the second case, a reoperation with duodenal ligation and Roux-en-Y jejunal anastomosis effectively managed a retroperitoneal duodenal injury with phlegmon.

Implications:

  • These case studies suggest that non-standard, individualized surgical interventions can achieve favorable outcomes in complex duodenal injuries.
  • The described techniques offer viable treatment options for specific, challenging cases of duodenal trauma and associated complications.