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Traumatic Duodenal Injury: Current Management Update

  • Trauma Surgery (J Diaz, Section Editor)
  • Published:
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Abstract

Purpose of Review

Although duodenal injuries are a rare entity of all trauma, they carry high risk of morbidity and mortality. The management of duodenal injuries should encompass a multidisciplinary approach. Optimal operative management of duodenal injuries has evolved in the last few decades.

Recent Findings

Isolated duodenal injuries are rare due to its proximity to major vascular and organ structures. Immediate mortality from duodenal injuries is due to hemorrhage from major vascular injuries. Non-operative management of isolated low-grade classification of duodenal injuries is accepted with close clinical and laboratory monitoring of patients. When operative management is necessary, recent evidence suggests simple repair over complex reconstructions that carry less morbidity and improved outcomes. When dealing with injuries to the duodenopancreas complex, reconstruction of the pancreaticobiliary system should involve expertise of hepatobiliary surgeons.

Summary

Management of duodenal injuries and its complications should engage a multidisciplinary approach. Damage control techniques should be utilized in patients in extremis with associated major vascular injuries. Low-grade duodenal injuries may be monitored closely with clinical examinations and laboratory values. When duodenal repair is needed, conservative repair techniques over complex reconstructions should be utilized.

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Authors and Affiliations

  1. Division of Trauma and Critical Care, Department of Surgery, Crozer-Keystone Healthcare System, Chester, PA, USA

    Asanthi Ratnasekera

  2. Division of Trauma and Critical Care, Department of Surgery, Virginia Commonwealth University, PO Box 980454, Richmond, VA, 23298-0454, USA

    Paula Ferrada

  3. West Hospital, 15th Floor, East Wing, 1200 E. Broad St., Richmond, VA, 23298, USA

    Paula Ferrada

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  1. Asanthi Ratnasekera
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  2. Paula Ferrada
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Correspondence to Paula Ferrada.

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Asanthi Ratnasekera and Paula Ferrada declare no conflicts of interest.

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This article is part of the Topical Collection on Trauma Surgery.

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Ratnasekera, A., Ferrada, P. Traumatic Duodenal Injury: Current Management Update. Curr Surg Rep 8, 6 (2020). https://doi.org/10.1007/s40137-020-00251-9

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