Skip to main content
Top
Published in: European Journal of Trauma and Emergency Surgery 6/2010

01-12-2010 | Case Report

Management of isolated duodenal rupture due to blunt abdominal trauma: case series and literature review

Authors: A. Celik, E. Altinli, N. Koksal, E. Onur, A. Sumer, M. Ali Uzun, M. Kayahan

Published in: European Journal of Trauma and Emergency Surgery | Issue 6/2010

Login to get access

Abstract

Introduction

Duodenal injuries are uncommon and are associated with significant morbidity and mortality due to delayed diagnosis (in the case of blunt trauma) or associated major vascular injuries (in the case of penetrating trauma). Isolated blunt injuries may have a subtle clinical presentation, and are particularly difficult to diagnose when the perforation is located in the retroperitoneal part of the duodenum.

Materials and methods

This paper presents in company with three cases of successfully treated isolated duodenal injuries due to blunt trauma, focusing on with their preoperative diagnosis, surgical management and final out comes.

Conclusions

Early diagnosis and successful surgical planning require experience and clinical suspicion on the part of the surgeon, as well as meticulous laparotomy results.
Literature
1.
go back to reference Asensio JA, Feliciano DV, Britt LD, Kerstein MD. Management of duodenal injuries. Curr Probl Surg. 1993;30(11):1023–93.CrossRefPubMed Asensio JA, Feliciano DV, Britt LD, Kerstein MD. Management of duodenal injuries. Curr Probl Surg. 1993;30(11):1023–93.CrossRefPubMed
2.
go back to reference Asensio JA, Stewart BM, Demetriades D. Duodenum. In: Ivatury RR, Cayten CG, editors. The textbook of penetrating trauma. Baltimore: Williams & Wilkins; 1996. p. 610–29. Asensio JA, Stewart BM, Demetriades D. Duodenum. In: Ivatury RR, Cayten CG, editors. The textbook of penetrating trauma. Baltimore: Williams & Wilkins; 1996. p. 610–29.
3.
go back to reference Jurkovich GJ. Injury to the duodenum and pancreas. In: Feliciano DV, Moore EE, Mattox KL, editors. Trauma. 3rd ed. Stamford: Appleton & Lange; 1996. p. 573–94. Jurkovich GJ. Injury to the duodenum and pancreas. In: Feliciano DV, Moore EE, Mattox KL, editors. Trauma. 3rd ed. Stamford: Appleton & Lange; 1996. p. 573–94.
4.
go back to reference Boone DC, Peitzman AB. Abdominal injury—duodenum and pancreas. In: Peitzman AB, Rhodes M, Schwab SW, Yealy DM, editors. The trauma manual. Philadelphia: Lippincott-Raven; 1998. p. 242–7. Boone DC, Peitzman AB. Abdominal injury—duodenum and pancreas. In: Peitzman AB, Rhodes M, Schwab SW, Yealy DM, editors. The trauma manual. Philadelphia: Lippincott-Raven; 1998. p. 242–7.
6.
go back to reference Moore EE, Cogbill TH, Malangoni MA, Jurkovich GJ, Champion HR, Gennarelli TA, et al. Organ injury scaling, II: pancreas, duodenum, small bowel, colon, and rectum. J Trauma. 1990;30(11):1427–9.CrossRefPubMed Moore EE, Cogbill TH, Malangoni MA, Jurkovich GJ, Champion HR, Gennarelli TA, et al. Organ injury scaling, II: pancreas, duodenum, small bowel, colon, and rectum. J Trauma. 1990;30(11):1427–9.CrossRefPubMed
7.
go back to reference Wisner DH, Hoyt DB. Definitive care phase: abdominal injuries. In: Greenfield LJ, Mulholland M, Oldham KT, Zelenock GB, Lillemoe KD, editors. Surgery: scientific principles and practice. Philadelphia: Lippincott Williams & Wilkins; 1997. p. 331–41. Wisner DH, Hoyt DB. Definitive care phase: abdominal injuries. In: Greenfield LJ, Mulholland M, Oldham KT, Zelenock GB, Lillemoe KD, editors. Surgery: scientific principles and practice. Philadelphia: Lippincott Williams & Wilkins; 1997. p. 331–41.
8.
go back to reference Allen GS, Moore FA, Cox CS Jr, Mehall JR, Duke JH. Delayed diagnosis of blunt duodenal injury: an avoidable complication. J Am Coll Surg. 1998;187(4):393–9.CrossRefPubMed Allen GS, Moore FA, Cox CS Jr, Mehall JR, Duke JH. Delayed diagnosis of blunt duodenal injury: an avoidable complication. J Am Coll Surg. 1998;187(4):393–9.CrossRefPubMed
9.
go back to reference Carrillo EH, Richardson JD, Miller FB. Evolution in the management of duodenal injuries. J Trauma. 1996;40(6):1037–45, discussion 1045–6.CrossRefPubMed Carrillo EH, Richardson JD, Miller FB. Evolution in the management of duodenal injuries. J Trauma. 1996;40(6):1037–45, discussion 1045–6.CrossRefPubMed
10.
go back to reference Huerta S, Bui T, Porral D, Lush S, Cinat M. Predictors of morbidity and mortality in patients with traumatic duodenal injuries. Am Surg. 2005;71(9):763–7.PubMed Huerta S, Bui T, Porral D, Lush S, Cinat M. Predictors of morbidity and mortality in patients with traumatic duodenal injuries. Am Surg. 2005;71(9):763–7.PubMed
11.
go back to reference Crippa S, Falconi M, Bettini R, Barugola G, Germenia S, Salvia R, et al. Isolated blunt duodenal trauma: delayed diagnosis and favorable outcome with “quadruple tube” decompression. JOP. 2007;8(5):617–20.PubMed Crippa S, Falconi M, Bettini R, Barugola G, Germenia S, Salvia R, et al. Isolated blunt duodenal trauma: delayed diagnosis and favorable outcome with “quadruple tube” decompression. JOP. 2007;8(5):617–20.PubMed
12.
go back to reference Fang JF, Chen RJ, Lin BC. Surgical treatment and outcome after delayed diagnosis of blunt duodenal injury. Eur J Surg. 1999;165(2):133–9.CrossRefPubMed Fang JF, Chen RJ, Lin BC. Surgical treatment and outcome after delayed diagnosis of blunt duodenal injury. Eur J Surg. 1999;165(2):133–9.CrossRefPubMed
13.
go back to reference Ivatury RR, Malhotra AK, Aboutanos MB, Duane TM. Duodenal injuries: a review. Eur J Trauma Emerg Surg. 2007;33:231–7.CrossRef Ivatury RR, Malhotra AK, Aboutanos MB, Duane TM. Duodenal injuries: a review. Eur J Trauma Emerg Surg. 2007;33:231–7.CrossRef
14.
go back to reference Thomas M, Basu NN, Gulati MS, Seager R, Oke T, Constantinescu G, et al. Isolated duodenal rupture due to go-karting accidents—braking news. Ann R Coll Surg Engl. 2009;91(4):340–3.CrossRefPubMed Thomas M, Basu NN, Gulati MS, Seager R, Oke T, Constantinescu G, et al. Isolated duodenal rupture due to go-karting accidents—braking news. Ann R Coll Surg Engl. 2009;91(4):340–3.CrossRefPubMed
15.
go back to reference Celik A, Altinli E, Onur E, Sumer A, Koksal N. Isolated duodenal rupture due to blunt abdominal trauma. Indian J Crit Care Med. 2006;10:44–6.CrossRef Celik A, Altinli E, Onur E, Sumer A, Koksal N. Isolated duodenal rupture due to blunt abdominal trauma. Indian J Crit Care Med. 2006;10:44–6.CrossRef
16.
go back to reference DuBose JJ, Inaba K, Teixeira PG, Shiflett A, Putty B, Green DJ, et al. Pyloric exclusion in the treatment of severe duodenal injuries: results from the National Trauma Data Bank. Am Surg. 2008;74(10):925–9.PubMed DuBose JJ, Inaba K, Teixeira PG, Shiflett A, Putty B, Green DJ, et al. Pyloric exclusion in the treatment of severe duodenal injuries: results from the National Trauma Data Bank. Am Surg. 2008;74(10):925–9.PubMed
17.
go back to reference Fang JF, Chen RJ, Lin BC, Hsu YB, Kao JL, Kao YC, et al. Retroperitoneal laparostomy: an effective treatment of extensive intractable retroperitoneal abscess after blunt duodenal trauma. J Trauma. 1999;46(4):652–5.CrossRefPubMed Fang JF, Chen RJ, Lin BC, Hsu YB, Kao JL, Kao YC, et al. Retroperitoneal laparostomy: an effective treatment of extensive intractable retroperitoneal abscess after blunt duodenal trauma. J Trauma. 1999;46(4):652–5.CrossRefPubMed
18.
go back to reference Champault A, Roudié J, Smadja C. Traumatic duodenal necrosis with peri-ampullary duodenal detachment. J Pediatr Surg. 2004;39(7):1136–7.CrossRefPubMed Champault A, Roudié J, Smadja C. Traumatic duodenal necrosis with peri-ampullary duodenal detachment. J Pediatr Surg. 2004;39(7):1136–7.CrossRefPubMed
19.
go back to reference Jordan GJ Jr. Injury to the pancreas and duodenum. In: Moore EE, Mattox KL, Feliciano DV, editors. Trauma. 2nd ed. Norwalk: Appleton & Lange; 1991. p. 498–510. Jordan GJ Jr. Injury to the pancreas and duodenum. In: Moore EE, Mattox KL, Feliciano DV, editors. Trauma. 2nd ed. Norwalk: Appleton & Lange; 1991. p. 498–510.
21.
go back to reference Yutan E, Waitches GM, Karmy-Jones R. Blunt duodenal rupture: complementary roles of sonography and CT. Am J Roentgenol. 2000;175(6):1600. Yutan E, Waitches GM, Karmy-Jones R. Blunt duodenal rupture: complementary roles of sonography and CT. Am J Roentgenol. 2000;175(6):1600.
22.
go back to reference Nassoura ZE, Ivatury RR, Simon RJ, Kihtir T, Stahl WM. A prospective reappraisal of primary repair of penetrating duodenal injuries. Am Surg. 1994;60(1):35–9.PubMed Nassoura ZE, Ivatury RR, Simon RJ, Kihtir T, Stahl WM. A prospective reappraisal of primary repair of penetrating duodenal injuries. Am Surg. 1994;60(1):35–9.PubMed
23.
go back to reference Ivatury RR, Nassoura ZE, Simon RJ, Rodriguez A. Complex duodenal injuries. Surg Clin North Am. 1996;76:797–812.CrossRefPubMed Ivatury RR, Nassoura ZE, Simon RJ, Rodriguez A. Complex duodenal injuries. Surg Clin North Am. 1996;76:797–812.CrossRefPubMed
24.
go back to reference Velmahos GC, Constantinou C, Kasotakis G. Safety of repair for severe duodenal injuries. World J Surg. 2008;32(1):7–12.CrossRefPubMed Velmahos GC, Constantinou C, Kasotakis G. Safety of repair for severe duodenal injuries. World J Surg. 2008;32(1):7–12.CrossRefPubMed
25.
go back to reference Leppäniemi A. Focus on pancreatic and duodenal injuries. Eur J Trauma Emerg Surg. 2007;33:219–20.CrossRef Leppäniemi A. Focus on pancreatic and duodenal injuries. Eur J Trauma Emerg Surg. 2007;33:219–20.CrossRef
Metadata
Title
Management of isolated duodenal rupture due to blunt abdominal trauma: case series and literature review
Authors
A. Celik
E. Altinli
N. Koksal
E. Onur
A. Sumer
M. Ali Uzun
M. Kayahan
Publication date
01-12-2010
Publisher
Urban and Vogel
Published in
European Journal of Trauma and Emergency Surgery / Issue 6/2010
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-010-0055-4

Other articles of this Issue 6/2010

European Journal of Trauma and Emergency Surgery 6/2010 Go to the issue