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J Trauma Inj > Volume 28(3); 2015 > Article
Journal of Trauma and Injury 2015;28(3):129-133.
DOI: https://doi.org/10.20408/jti.2015.28.3.129    Published online September 30, 2015.
Treatment Outcomes of Traumatic Duodenal Injury
Byunghyuk Yu, Jayun Cho, Kyoung Hoon Lim, Jinyoung Park
Department of Surgery, Kyungpook National University, School of Medicine, Trauma Center, Daegu, Korea. kpnugs@knu.ac.kr
외상성 십이지장 손상의 치료 성적
유병혁, 조자윤, 임경훈, 박진영
경북대학교 의과대학 외과학교실, 외상센터
Received: 2 July 2015   • Revised: 24 August 2015   • Accepted: 4 October 2015
Abstract
PURPOSE
The purpose of this study is to evaluate the surgical outcome of duodenal injuries and to analyze the risk factors related to the leakage after surgical treatment.
METHODS
A retrospective review of 31 patients with duodenal injuries who managed by surgical treatment was conducted from December 2000 to May 2014. The demographic characteristics, injury mechanism, site of duodenal injury, association of intraabdominal organ injuries, injury severity score (ISS), abdominal abbreviated injury scale (AIS), injury-operation time lag, surgical treatment methods, complications, and mortality were reviewed.
RESULTS
Duodenal injury was more common in male. Twenty four (77.4%) patients were injured by blunt trauma. The most common injury site was in the second portion of the duodenum (n=19, 58.6%). Fourteen patients (45.2%) had other associated intraabdominal organ injuries. The mean ISS is 13.6+/-9.6. The mean AIS is 8.9+/-6.5. Eighteen patients (58.1%) were treated by primary closure. The remaining 13 patients underwent various operations, including exploratory laparotomy (n=4), pancreaticoduodenectomy (n=3), pyloric exclusion (n=3), Resection with end-to-end anastomosis (n=2), and duodenojejunostomy (n=1). Most common postoperative complications were intraabdominal abscess (n=9) and renal failure (n=9). Mortality rate was 9.7%.
CONCLUSION
ISS, AIS>10, operative time, pancreaticoduodenectomy, sepsis, and renal failure are significant predictors of a postoperative leak after duodenal injury. Careful management is needed to prevent a potential leak in patient with these findings.
Key Words: Abdominal trauma; Duodenal injuries; Leakage; Risk factors


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