Abstract
Introduction
Duodenal injuries are uncommon and are associated with significant morbidity and mortality due to delayed diagnosis (in the case of blunt trauma) or associated major vascular injuries (in the case of penetrating trauma). Isolated blunt injuries may have a subtle clinical presentation, and are particularly difficult to diagnose when the perforation is located in the retroperitoneal part of the duodenum.
Materials and methods
This paper presents in company with three cases of successfully treated isolated duodenal injuries due to blunt trauma, focusing on with their preoperative diagnosis, surgical management and final out comes.
Conclusions
Early diagnosis and successful surgical planning require experience and clinical suspicion on the part of the surgeon, as well as meticulous laparotomy results.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Asensio JA, Feliciano DV, Britt LD, Kerstein MD. Management of duodenal injuries. Curr Probl Surg. 1993;30(11):1023–93.
Asensio JA, Stewart BM, Demetriades D. Duodenum. In: Ivatury RR, Cayten CG, editors. The textbook of penetrating trauma. Baltimore: Williams & Wilkins; 1996. p. 610–29.
Jurkovich GJ. Injury to the duodenum and pancreas. In: Feliciano DV, Moore EE, Mattox KL, editors. Trauma. 3rd ed. Stamford: Appleton & Lange; 1996. p. 573–94.
Boone DC, Peitzman AB. Abdominal injury—duodenum and pancreas. In: Peitzman AB, Rhodes M, Schwab SW, Yealy DM, editors. The trauma manual. Philadelphia: Lippincott-Raven; 1998. p. 242–7.
Degiannis E, Boffard K. Duodenal injuries. Br J Surg. 2000;87(11):1473–9.
Moore EE, Cogbill TH, Malangoni MA, Jurkovich GJ, Champion HR, Gennarelli TA, et al. Organ injury scaling, II: pancreas, duodenum, small bowel, colon, and rectum. J Trauma. 1990;30(11):1427–9.
Wisner DH, Hoyt DB. Definitive care phase: abdominal injuries. In: Greenfield LJ, Mulholland M, Oldham KT, Zelenock GB, Lillemoe KD, editors. Surgery: scientific principles and practice. Philadelphia: Lippincott Williams & Wilkins; 1997. p. 331–41.
Allen GS, Moore FA, Cox CS Jr, Mehall JR, Duke JH. Delayed diagnosis of blunt duodenal injury: an avoidable complication. J Am Coll Surg. 1998;187(4):393–9.
Carrillo EH, Richardson JD, Miller FB. Evolution in the management of duodenal injuries. J Trauma. 1996;40(6):1037–45, discussion 1045–6.
Huerta S, Bui T, Porral D, Lush S, Cinat M. Predictors of morbidity and mortality in patients with traumatic duodenal injuries. Am Surg. 2005;71(9):763–7.
Crippa S, Falconi M, Bettini R, Barugola G, Germenia S, Salvia R, et al. Isolated blunt duodenal trauma: delayed diagnosis and favorable outcome with “quadruple tube” decompression. JOP. 2007;8(5):617–20.
Fang JF, Chen RJ, Lin BC. Surgical treatment and outcome after delayed diagnosis of blunt duodenal injury. Eur J Surg. 1999;165(2):133–9.
Ivatury RR, Malhotra AK, Aboutanos MB, Duane TM. Duodenal injuries: a review. Eur J Trauma Emerg Surg. 2007;33:231–7.
Thomas M, Basu NN, Gulati MS, Seager R, Oke T, Constantinescu G, et al. Isolated duodenal rupture due to go-karting accidents—braking news. Ann R Coll Surg Engl. 2009;91(4):340–3.
Celik A, Altinli E, Onur E, Sumer A, Koksal N. Isolated duodenal rupture due to blunt abdominal trauma. Indian J Crit Care Med. 2006;10:44–6.
DuBose JJ, Inaba K, Teixeira PG, Shiflett A, Putty B, Green DJ, et al. Pyloric exclusion in the treatment of severe duodenal injuries: results from the National Trauma Data Bank. Am Surg. 2008;74(10):925–9.
Fang JF, Chen RJ, Lin BC, Hsu YB, Kao JL, Kao YC, et al. Retroperitoneal laparostomy: an effective treatment of extensive intractable retroperitoneal abscess after blunt duodenal trauma. J Trauma. 1999;46(4):652–5.
Champault A, Roudié J, Smadja C. Traumatic duodenal necrosis with peri-ampullary duodenal detachment. J Pediatr Surg. 2004;39(7):1136–7.
Jordan GJ Jr. Injury to the pancreas and duodenum. In: Moore EE, Mattox KL, Feliciano DV, editors. Trauma. 2nd ed. Norwalk: Appleton & Lange; 1991. p. 498–510.
Olsen WR. The serum amylase in blunt abdominal trauma. J Trauma. 1973;13(3):200–4.
Yutan E, Waitches GM, Karmy-Jones R. Blunt duodenal rupture: complementary roles of sonography and CT. Am J Roentgenol. 2000;175(6):1600.
Nassoura ZE, Ivatury RR, Simon RJ, Kihtir T, Stahl WM. A prospective reappraisal of primary repair of penetrating duodenal injuries. Am Surg. 1994;60(1):35–9.
Ivatury RR, Nassoura ZE, Simon RJ, Rodriguez A. Complex duodenal injuries. Surg Clin North Am. 1996;76:797–812.
Velmahos GC, Constantinou C, Kasotakis G. Safety of repair for severe duodenal injuries. World J Surg. 2008;32(1):7–12.
Leppäniemi A. Focus on pancreatic and duodenal injuries. Eur J Trauma Emerg Surg. 2007;33:219–20.
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Celik, A., Altinli, E., Koksal, N. et al. Management of isolated duodenal rupture due to blunt abdominal trauma: case series and literature review. Eur J Trauma Emerg Surg 36, 573–578 (2010). https://doi.org/10.1007/s00068-010-0055-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00068-010-0055-4