Panamerican Journal of Trauma, Critical Care & Emergency Surgery

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VOLUME 7 , ISSUE 1 ( January-April, 2018 ) > List of Articles

ORIGINAL ARTICLE

Trauma Duodenal Penetrante: Manejo Quirúrgico

Gustavo Rodríguez, Julio Trostchansky, Javier Chinelli, Juan Costa, Florencia Rodriguez, Cecilia Laguzzi

Keywords : Duodenal injury, Duodenal trauma, Penetrating abdominal trauma

Citation Information : Rodríguez G, Trostchansky J, Chinelli J, Costa J, Rodriguez F, Laguzzi C. Trauma Duodenal Penetrante: Manejo Quirúrgico. Panam J Trauma Crit Care Emerg Surg 2018; 7 (1):47-51.

DOI: 10.5005/jp-journals-10030-1203

License: CC BY-NC 4.0

Published Online: 01-04-2018

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction: Duodenal injuries from penetrating trauma are infrequent, and most are from gunshot wounds. They constitute a therapeutic challenge and the current evidence for recommending complex repair procedures continues to be scarce. Objectives: To review the surgical management of a series of patients with penetrating duodenal trauma assisted in the Emergency Department of Hospital Maciel in the period 2009 to 2016. Materials and methods: Retrospective, observational, and descriptive study. The study included 16 patients, and obtained data from the clinical histories. The main endpoints were: type of injury according to American Association for the Surgery of Trauma–Organ Injury Scaling classification, lesion association, type of duodenal repair, and repair failure. Results: The mean age was 25.6 years; 15 patients had type II lesions and 1 had type IV lesion. All were associated with other intra-abdominal injuries. The initial management was duodenorrhaphy in all cases, requiring duodenal exclusion later in a patient. In one case there was a failure of duodenorrhaphy and 5 patients died (31%). Discussion: Duodenorrhaphy is the procedure of choice for most duodenal lesions. Current evidence is not yet sufficient to recommend or abandon the use of adjacent techniques of greater complexity to decrease the rate of complications of duodenal repair. Conclusion: O ur s eries s howed r esults s imilar t o t hose described in the literature, with a high percentage of resolution by simple raphy, associated injuries in all cases, and bimodal mortality curve.


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