Abstract
Background
Although blunt abdominal trauma is frequently encountered, isolated duodenal injury is relatively uncommon. The management of such patients is challenging and various surgical procedures are described for their management.
Methods
Two patients presented to our emergency department with isolated duodenal injuries (transection and devascularisation) secondary to blunt abdominal trauma.
Results
Both patients underwent exploratory laparotomy, revealing transection of the duodenum along with proximal devascularization and detachment of mesentery at duodeno-jejunal junction without any other intra-abdominal injury (especially pancreas, colon, vena cava) for which pancreas-sparing duodenectomy (infra-ampullary) was performed.
Conclusion
Pancreas-sparing duodenectomy is a valuable tool in the management of duodenal trauma, allowing the surgeon (and the patient) to avoid the complications of major surgical resections.
Similar content being viewed by others
References
Madhumita M. Intestinal injury from blunt abdominal trauma: A Study of 47 Cases. Oman Med J 2009;24:256–9.
Sadllah G, Ercan G, Yusuf Y, et al. Management of duodenal injury: Our experience and the value of tube duodenostomy Ulus Travrna Acil Cerrahi Derg 2009;15:467–2.
Chung RS, Church JM, VanStolk R. Pancreas-sparing duodenectomy: indications, surgical technique, and results. Surgery 1995;117:254–9.
Penning L, Svendsen LB. Pancreas-preserving total duodenectomy: a 10-year experience. J Hepatobiliary Pancreat Sci 2011;18:717–23.
Esther GS, Ana SS, Juan MV, et al. Duodenal injuries due to trauma: Review of the Literature. Cir Esp 2015;93:68–74.
Pandey S, Niranjan A, Mishra S, et al. Retrospective analysis of duodenal injuries: A comprehensive overview. Saudi J Gastroenterol 2011;17:142–4.
Kurane SB, Ugane SP, Walvekar RS. A study of isolated duodenal rupture following blunt abdominal trauma and review of literature. Int J Clin Surg Adv 2014;2:1–8.
Geoghegan T, Brush BE. The mechanism of intestinal perforation from non-penetrating abdominal trauma. Arch Surg 1956;73:455–64.
Toxopeus MD, Lucas CE, Krabbenhoft KL. Roentgenographic diagnosis in blunt retroperitoneal duodenal rupture. Am J of Roentgenol 1972;115:281–8.
Hoffmann B, Nurnberg D, Westergaard MC. Focus on abnormal air: Diagnostic ultrasonography for the acute abdomen. European Journal of Emergency Medicine 2012;19:284–91.
Linsenmaier U, Wirth S, Reiser M, et al. Diagnosis and classification of pancreatic and duodenal injuries in emergency radiology. Radiographics 2008;28:1591–601.
Ballard R, Badellino M, Eynon A, et al. Blunt duodenal rupture: a 6-year statewide experience. J Trauma 1997;43:229–33.
Jansen M, Du Tuit DF, Warren BL. Duodenal injuries: surgical management adapted to circumstances. Injury 2002;33:611–5.
Lucas CE. The therapeutic challenges in treating duodenal injury. Pan J Trauma 2013;2:126–33.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kataria, H., Kaushik, R., Singh, S. et al. Pancreas sparing duodenectomy for duodenal trauma. Hellenic J Surg 89, 121–125 (2017). https://doi.org/10.1007/s13126-017-0395-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13126-017-0395-1