Rationale: Duodenal injuries are rare and most common due
to penetrating abdominal trauma, especially gunshot wounds,
with greatest prevalence among young men. Achieving simpler
and more effective surgical procedures also contributes to the
reduction of mortality and morbidity rates.
Objective: Review cases of penetrating and blunt duodenal
trauma, the complexity of the injuries, incidence, management
as well as morbidity and mortality.
Materials and methods: At Grajaú General Hospital, between
January 2010 and May 2014, a retrospective analysis of 1,039
patients’ medical records who had undergone emergency
exploratory laparotomies was done. From these cases, 298
were caused by blunt and penetrating abdominal traumas, and
11 suffered duodenal traumas.
Results: It was observed that there was a predominance of young
adults (mean age 26.48 years) and all patients were males (100%),
of which one injury was from blunt abdominal trauma, three from
stab wounds, and seven caused by firearm. Most of the duodenal
injuries were classified as grade II injuries and most commonly
involved the fourth portion of the duodenum. We emphasize
the association with injuries to other organs, especially the liver
and the small intestine. In the cases we analyzed, we highlight
the importance of time between entry of service and surgery in
all patients being less than 6 hours. The most common surgery
performed to repair these injuries was duodenorrhaphy (90.9%).
In this series, there were four deaths. Postoperative complications
included duodenal fistulae with spontaneous resolution.
Conclusion: Duodenal injuries are rare, and are most
commonly due to penetrating abdominal trauma, especially
gunshot wounds, with the greatest prevalence among young
men. There is a need for early diagnosis and rapid surgical
intervention, shortened and effective surgical procedures, due
to the morbidity/mortality and high complexity of these injuries.
This emphasizes the importance of early intervention in the
short time before surgical procedure takes place.
Keywords: Abdominal trauma, Duodenal/trauma, Duodenum/
injuries, Wounds and injuries.
How to cite this article: Ribeiro MAF Jr, Rosa OM, Filho OC,
Santin S, Fonseca AZ, Alvarez BE, Parra MW. Duodenal Trauma:
Incidence and Management in Penetrating and Blunt Abdominal
Trauma. Panam J Trauma Crit Care Emerg Surg 2017;6(1):13-16.
Source of support: Nil
Conflict of interest: None