- Surgical Management of Duodenal Traumatic Injuries: A Single Center Study
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Oh Hyun Park, Yun Chul Park, Dong Gyu Lee, Ho Hyun Kim, Chan Yong Park, Jung Chul Kim
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J Trauma Inj. 2013;26(3):157-162.
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 Abstract
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- PURPOSE
Abdominal trauma rarely causes injuries involving duodenum. But, it is associated with higher rate of the complication and mortality than other abdominal injuries. There are many options for the management of duodenal injuries. Herein we are to review our experiences and find out the risk factors related to the morbidity and the mortality in traumatic duodenal injuries.
METHODS
The medical records of total 25 patients who managed by surgical managements and survive more than 48 hours were conducted from January 2006 to December 2012. The clinical characteristics, treatments, and outcomes are reviewed.
RESULTS
Among 25 patients, most of them (n=17, 68.0%) were managed by the pyloric exclusion and the gastrojejunostomy. The 3rd portion is the most injured site (n=15, 60.0%), and the majority exhibited grade 2 severity (n=14, 56.0%). Most of patients had blunt abdominal traumas (n=23, 92.0%) so that many of them (n=14, 56.0%) had other combined abdominal injuries. The mean ISS is 11.5+/-6.2. The surgery related mortality rate was 28.0%. There was no statistical significance between each factors and the mortality except leakage (p=0.012). But, we could find some trends about traumatic duodenal injuries in this study. The mortality rates of them who older than 55 years were higher than others. And, all 3 patients who delayed the operation more than 24 hours after the trauma had some complications or died. Also, the patients who had the 2nd portion injury, grade 3 injury, or combined abdominal injury were less survived.
CONCLUSION
Duodenal injury is related to high rate of morbidity(47.8%) and mortality(28.0%). Age, portion of injury, OIS grade, ISS>15, combined intra-abdominal operation, and trauma to operation time over 24 hrs have some trend with attribution to mortality. Especially leakage of duodenal injury is related to mortality.
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Summary
- Cerebral Fat Embolism after Traumatic Multiple Fracture: A Case Report
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Ho Hyun Kim, Yun Chul Park, Dong Kyu Lee, Chan Yong Park, Jae Hun Kim, Yeong Dae Kim, Jung Chul Kim
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J Trauma Inj. 2013;26(2):58-62.
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- A cerebral fat embolism is an uncommon but serious complication of long bone fracture. It can be fatal, and early detection is not easy. Neurologic symptoms are variable, and the clinical diagnosis is difficult. The pathogenesis remains controversial, and several theories have been proposed. Magnetic resonance imaging can detect a cerebral fat embolism with a higher sensitivity than cerebral computed tomography. We report a case of a post-traumatic cerebral fat embolism without pulmonary involvement and review the existing literature.
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- Traumatic Perforation of the Duodenal Diverticulum: A Case Report
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Ho Hyun Kim, Yun Chul Park, Dong Kyu Lee, Chan Yong Park, Jae Hun Kim, Yeong Dae Kim, Jung Chul Kim
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J Trauma Inj. 2013;26(2):53-57.
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- A duodenal diverticulum is a frequent abnormality that is usually diagnosed incidentally. Clinical manifestations usually mimic those of highly-varied entities. Among the complications of a duodenal diverticulum, perforation is fairly rare; rupture due to blunt trauma is even rarer, and no cases have been reported in Korean literature. We report the case of a 61-year-old male patient who presented with a perforated duodenal diverticulum after a blunt trauma. We also review the existing literature.
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