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Journal of Trauma and Injury 2013;26(3):157-162.
Surgical Management of Duodenal Traumatic Injuries: A Single Center Study
Oh Hyun Park, Yun Chul Park, Dong Gyu Lee, Ho Hyun Kim, Chan Yong Park, Jung Chul Kim
Division of Trauma, Department of Surgery, Chonnam National University Medical School, Gwangju, Korea. iso5hyun@hanmail.net
외상성 십이지장 손상의 수술적 치료: 단일 기관 연구
박오현, 박윤철, 이동규, 김호현, 박찬용, 김정철
전남대학교 의과대학 외과학교실
Received: 15 May 2013   • Revised: 22 August 2013   • Accepted: 2 September 2013
Abstract
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.
Key Words: Abdominal trauma; Duodenal injuries; Risk factors


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