Shaikh, Ghulam Shabir; Shaikh, Shahida; Baloch, Imamuddin
January 2011
Medical Channel;Jan2011, Vol. 17 Issue 1, p19
Academic Journal
Objective: The purpose of this study was to share our surgical experience of duodenal injuries in past 3 years and to evaluate outcome different surgical approaches. Patients and Method: 32 consecutive patients diagnosed with traumatic duodenal injuries admitted to CMCTH during 3 years period from March 2007 to February 2010 were retrospectively analyzed. The data collected on study specific Proforma included demographic data, cause of injury, number and size of injury, anatomic location of duodenal injury, grade of duodenal injury, surgical procedures performed, morbidity and mortality. Results: During the period under study a total of 32 consecutive patients with duodenal injuries were included in the study. There were 29 (90.6%) male and 3 (9.4%) female with male to female ratio of 9:1 and mean age of 27.8 years. 78.12% cases were due to penetrating injuries predominantly firearm injuries and 22.98% were due to blunt trauma. second part of duodenum was found to be the most commonly injured site in 53% case and grade III injuries accounted for 53% of total injuries. Two of the three female patients having the associated injuries to pelvic organs like uterus were, managed with gynecologist. Note: The most common operative procedure performed was primary repair with and without Tube Duodenostomy. Post-operatively 6.25% cases developed duodenal fistula, and the overall morbidity was found to be 34.37% and mortality 28%. Conclusion: The duodenal trauma is an uncommon injury associated with the significant morbidity and mortality. Their detection can be challenging due to the retroperitoneal location. Exploratory laparotomy remains as the ultimate diagnostic test, even in the face of absent or equivocal radiographic signs. Treatment of injured duodenum varies, according to severity of injury, degree of contamination of the peritoneal cavity, associated organs injury and duration before diagnosis. Therefore early diagnosis and appropriate surgical repair are the keys to good outcome and improved survival.


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