Duodenal Injuries at Maharat Nakhon Ratchasima Hospital: a Report of 24 Patients
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Abstract
Background: Duodenum and pancreatic injuries are uncommon. Delays in the diagnosis and repair can make surgical management a more complex and technically challenging task, and increase morbidity and mortality. The management of duodenal traumas are controversy. Patients & Methods: Between January 2005 and December 2007, 24 patients with duodenal injury were admitted and operated in our institution. The injuries were blunt in 19 patients and penetrating in 5 patients. Primary repair was performed in 9 patients, pyloric exclusion in 7 patients, triple ostomy in 3 patients, and complex repair in 2 patients. Results: Twenty four patients were included in this study. Three patients had duodenal injury grade I, 10 patients had duodenal injury grade II, 9 patients had duodenal injury grade III and 2 patients had duodenal injury grade IV, V. The mortality rate was 8.3% (2 patients). Duodenum-related mobidities were such as fistula, intraabdominal collection, surgical site infection, sepsis, and gut obstruction. Conclusion: Duodenal injuries are uncommon and difficult to manage. Delays in the diagnosis and surgical repair of duodenal injuries result in increased morbidity and mortality.
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