Skip to main content
SpringerLink
Log in
Book cover

Trauma Surgery pp 135–149Cite as

Surgical Treatment of Duodenal Trauma

  • Chapter
  • First Online:

Abstract

Duodenal injury remains to be a lethal injury. The high mortality and complication rates are due to difficulties in diagnosis resulting in delayed recognition and associated injuries such as pancreatic injury and retroperitoneal vascular injuries. Diagnosis can be done perioperatively or intraoperatively. Importantly, clinical judgments have to be based on the combination of mechanisms, clinical signs, and radiological evaluations if possible. In the operation, the strategy is usually simple including primary repair and omentum patch. Nevertheless, if more complicated procedures are required, the principles of damage control surgery need to be followed since definitive repair can be performed later. Although conservative treatment is possible, surgeons need to be aware of alternative options available.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   59.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   79.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Mayberry J, Fabricant L, Anton A et al (2011) Management of full-thickness duodenal laceration in the damage control era: evolution to primary repair without diversion or decompression. Am Surg 77:681–685

    PubMed  Google Scholar 

  2. Lopez PP, Benjamin R, Cockburn M et al (2005) Recent trends in the management of combined pancreatoduodenal injuries. Am Surg 71:847–852

    PubMed  Google Scholar 

  3. Ivatury RR, Gaudino J, Ascer E et al (1985) Treatment of penetrating duodenal injuries: primary repair vs. repair with decompressive enterostomy/serosal patch. J Trauma 25:337–341

    Article  CAS  PubMed  Google Scholar 

  4. Vaughan GD 3rd, Frazier OH, Graham DY et al (1977) The use of pyloric exclusion in the management of severe duodenal injuries. Am J Surg 134:785–790

    Article  PubMed  Google Scholar 

  5. Morton JR, Jordan GL Jr (1968) Traumatic duodenal injuries. Review of 131 cases. J Trauma 8:127–139

    Article  CAS  PubMed  Google Scholar 

  6. Allen GS, Moore FA, Cox CS Jr et al (1998) Hollow visceral injury and blunt trauma. J Trauma 45:69–75; discussion 75–78

    Article  CAS  PubMed  Google Scholar 

  7. Allen GS, Moore FA, Cox CS Jr et al (1998) Delayed diagnosis of blunt duodenal injury: an avoidable complication. J Am Coll Surg 187:393–399

    Article  CAS  PubMed  Google Scholar 

  8. Clendenon JN, Meyers RL, Nance ML, Scaife ER (2004) Management of duodenal injuries in children. J Pediatr Surg 39:964–968

    Article  CAS  PubMed  Google Scholar 

  9. Shilyansky J, Pearl RH, Kreller M et al (1997) Diagnosis and management of duodenal injuries in children. J Pediatr Surg 32:880–886

    Article  CAS  PubMed  Google Scholar 

  10. Asensio JA, Feliciano DV, Britt LD, Kerstein MD (1993) Management of duodenal injuries. Curr Probl Surg 30:1023–1093

    CAS  PubMed  Google Scholar 

  11. Moore EE, Cogbill TH, Malangoni MA et al (1990) Organ injury scaling, II: Pancreas, duodenum, small bowel, colon, and rectum. J Trauma 30:1427–1429

    Article  CAS  PubMed  Google Scholar 

  12. Ballard RB, Badellino MM, Eynon CA et al (1997) Blunt duodenal rupture: a 6-year statewide experience. J Trauma 43:229–232; discussion 33

    Article  CAS  PubMed  Google Scholar 

  13. Rodriguez C, Barone JE, Wilbanks TO et al (2002) Isolated free fluid on computed tomographic scan in blunt abdominal trauma: a systematic review of incidence and management. J Trauma 53:79–85

    Article  PubMed  Google Scholar 

  14. Mirvis SE, Gens DR, Shanmuganathan K (1992) Rupture of the bowel after blunt abdominal trauma: diagnosis with CT. AJR Am J Roentgenol 159:1217–1221

    Article  CAS  PubMed  Google Scholar 

  15. LeBedis CA, Anderson SW, Soto JA (2012) CT imaging of blunt traumatic bowel and mesenteric injuries. Radiol Clin North Am 50:123–136

    Article  PubMed  Google Scholar 

  16. Snyder WH 3rd, Weigelt JA, Watkins WL, Bietz DS (1980) The surgical management of duodenal trauma. Precepts based on a review of 247 cases. Arch Surg 115:422–429

    Article  PubMed  Google Scholar 

  17. Timaran CH, Martinez O, Ospina JA (1999) Prognostic factors and management of civilian penetrating duodenal trauma. J Trauma 47:330–335

    Article  CAS  PubMed  Google Scholar 

  18. Cogbill TH, Moore EE, Feliciano DV et al (1990) Conservative management of duodenal trauma: a multicenter perspective. J Trauma 30:1469–1475

    Article  CAS  PubMed  Google Scholar 

  19. Lucas CE, Ledgerwood AM (1975) Factors influencing outcome after blunt duodenal injury. J Trauma 15:839–846

    Article  CAS  PubMed  Google Scholar 

  20. Roman E, Silva YJ, Lucas C (1971) Management of blunt duodenal injury. Surg Gynecol Obstet 132:7–14

    CAS  PubMed  Google Scholar 

  21. Jansen M, Du Toit DF, Warren BL (2002) Duodenal injuries: surgical management adapted to circumstances. Injury 33:611–615

    Article  PubMed  Google Scholar 

  22. Antonacci N, Di Saverio S, Ciaroni V et al (2011) Prognosis and treatment of pancreaticoduodenal traumatic injuries: which factors are predictors of outcome? J Hepatobiliary Pancreat Sci 18:195–201

    Article  PubMed  Google Scholar 

  23. Jurkovich GJ, Bulger EM (2004) Duodenum and pancreas. In: Moore EE, Feliciano DV, Mattox KL (eds) Trauma, 5th edn. McGraw-Hill, New York

    Google Scholar 

  24. Seamon MJ, Pieri PG, Fisher CA et al (2007) A ten-year retrospective review: does pyloric exclusion improve clinical outcome after penetrating duodenal and combined pancreaticoduodenal injuries? J Trauma 62:829–833

    Article  PubMed  Google Scholar 

  25. Talving P, Nicol AJ, Navsaria PH (2006) Civilian duodenal gunshot wounds: surgical management made simpler. World J Surg 30:488–494

    Article  PubMed  Google Scholar 

  26. Berne CJ, Donovan AJ, Hagen WE (1968) Combined duodenal pancreatic trauma. The role of end-to-side gastrojejunostomy. Arch Surg 96:712–722

    Article  CAS  PubMed  Google Scholar 

  27. Martin TD, Feliciano DV, Mattox KL, Jordan GL Jr (1983) Severe duodenal injuries. Treatment with pyloric exclusion and gastrojejunostomy. Arch Surg 118:631–635

    Article  CAS  PubMed  Google Scholar 

  28. Delcore R, Stauffer JS, Thomas JH, Pierce GE (1994) The role of pancreatogastrostomy following pancreatoduodenectomy for trauma. J Trauma 37:395–400

    Article  CAS  PubMed  Google Scholar 

  29. Feliciano DV, Martin TD, Cruse PA et al (1987) Management of combined pancreatoduodenal injuries. Ann Surg 205:673–680

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  30. Mansour MA, Moore JB, Moore EE, Moore FA (1989) Conservative management of combined pancreatoduodenal injuries. Am J Surg 158:531–535

    Article  CAS  PubMed  Google Scholar 

  31. Jewett TC Jr, Caldarola V, Karp MP et al (1988) Intramural hematoma of the duodenum. Arch Surg 123:54–58

    Article  PubMed  Google Scholar 

  32. Nolan GJ, Bendinelli C, Gani J (2011) Laparoscopic drainage of an intramural duodenal haematoma: a novel technique and review of the literature. World J Emerg Surg 6:42

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, John Hunter Hospital and University of Newcastle, Locked Bag 1, Hunter Region Mail Centre, Newcastle, NSW, 2310, Australia

    Cino Bendinelli & Osamu Yoshino

Authors
  1. Cino Bendinelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Osamu Yoshino
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Cino Bendinelli .

Editor information

Editors and Affiliations

  1. Trauma Surgery Unit, Maggiore Hospital, Bologna, Italy

    S. Di Saverio

  2. Trauma Surgery Unit, Maggiore Hospital, Bologna, Italy

    G. Tugnoli

  3. Emergency and Trauma Surgery, Maggiore Hospital, Parma, Italy

    F. Catena

  4. General and Emergency Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy

    L. Ansaloni

  5. Surgery, Port Shepstone Regional Hospital, Durban, South Africa

    N. Naidoo

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag Italia

About this chapter

Cite this chapter

Bendinelli, C., Yoshino, O. (2014). Surgical Treatment of Duodenal Trauma. In: Di Saverio, S., Tugnoli, G., Catena, F., Ansaloni, L., Naidoo, N. (eds) Trauma Surgery. Springer, Milano. https://doi.org/10.1007/978-88-470-5459-2_10

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-5459-2_10

  • Published:

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-5458-5

  • Online ISBN: 978-88-470-5459-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation