Surgical Care for Duodenal Injuries

Abstract

A study of 50 consecutive cases of duodenal injuries managed in the surgical unit of Mayo Hospital, Lahore in the year 1994-1997 is presented. Ninety percent of patients were received, resuscitated and operated within 24 hours of injury. Penetrating injuries 38(76%) outnumbered the patients with blunt abdominal trauma 12(24%). Forty three patients (86%) had grade I, II and III duodenal injuries according to organ injury scale. Primary duodenal repair (68%), primary repair with gastrojejunostomy(10%), primary repair with jejunal serosal patch (8%), pyloric exclusion (4%), resection and primary anastomosis (6%), duodenal dirverticulization (2%) and emergency whipple procedure. (2%) were the procedures carried out. The determinants of duodenal injury severity were mode of injury, duodenal site, injury repair interval and adjacent injuries. Morbidity in this series was 70% and mortality 14%.