E Degiannis1, K Boffard. 1. Department of Surgery, Medical School, University of the Witwatersrand, Johannesburg, Republic of South Africa.
Abstract
BACKGROUND: The worldwide increase in road traffic accidents and use of firearms has increased the incidence of duodenal trauma. METHODS: The English language literature on duodenal trauma over the period 1970-1999 was reviewed. RESULTS AND CONCLUSION: Upper gastrointestinal radiological studies and computed tomography may lead to the diagnosis of blunt duodenal trauma. Exploratory laparotomy remains the ultimate diagnostic test if a high suspicion of duodenal injury continues in the face of absent or equivocal radiographic signs. The majority of duodenal injuries may be managed by simple repair. More complicated injuries require more sophisticated techniques. High-risk duodenal injuries are followed by a high incidence of suture line dehiscence and they should be treated by duodenal diversion. Pancreaticoduodenectomy should be considered only if no alternative is available. 'Damage control' should precede definitive reconstruction.
BACKGROUND: The worldwide increase in road traffic accidents and use of firearms has increased the incidence of duodenal trauma. METHODS: The English language literature on duodenal trauma over the period 1970-1999 was reviewed. RESULTS AND CONCLUSION: Upper gastrointestinal radiological studies and computed tomography may lead to the diagnosis of blunt duodenal trauma. Exploratory laparotomy remains the ultimate diagnostic test if a high suspicion of duodenal injury continues in the face of absent or equivocal radiographic signs. The majority of duodenal injuries may be managed by simple repair. More complicated injuries require more sophisticated techniques. High-risk duodenal injuries are followed by a high incidence of suture line dehiscence and they should be treated by duodenal diversion. Pancreaticoduodenectomy should be considered only if no alternative is available. 'Damage control' should precede definitive reconstruction.
Authors: Oral Saygun; Serdar Topaloglu; Fatih M Avsar; Hakan Ozel; Sema Hucumenoglu; Mustafa Sahin; Suleyman Hengirmen Journal: Can J Surg Date: 2006-04 Impact factor: 2.089
Authors: Tugba H Yilmaz; Brown C Ndofor; Martin D Smith; Elias Degiannis Journal: Scand J Trauma Resusc Emerg Med Date: 2010-07-14 Impact factor: 2.953