Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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Surgical Management of Duodenal Traumatic Injuries: A Single Center Study

외상성 십이지장 손상의 수술적 치료: 단일 기관 연구

  • Park, Oh Hyun (Division of Trauma, Department of Surgery, Chonnam National University Medical School) ;
  • Park, Yun Chul (Division of Trauma, Department of Surgery, Chonnam National University Medical School) ;
  • Lee, Dong Gyu (Division of Trauma, Department of Surgery, Chonnam National University Medical School) ;
  • Kim, Ho Hyun (Division of Trauma, Department of Surgery, Chonnam National University Medical School) ;
  • Park, Chan Yong (Division of Trauma, Department of Surgery, Chonnam National University Medical School) ;
  • Kim, Jung Chul (Division of Trauma, Department of Surgery, Chonnam National University Medical School)
  • 박오현 (전남대학교 의과대학 외과학교실) ;
  • 박윤철 (전남대학교 의과대학 외과학교실) ;
  • 이동규 (전남대학교 의과대학 외과학교실) ;
  • 김호현 (전남대학교 의과대학 외과학교실) ;
  • 박찬용 (전남대학교 의과대학 외과학교실) ;
  • 김정철 (전남대학교 의과대학 외과학교실)
  • Received : 2013.05.15
  • Accepted : 2013.09.02
  • Published : 2013.09.30
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Abstract

Purpose: Abdominal trauma rarely causes injuries involving duodenum. But, it is associated with higher rate of the complication and mortality than other abdominal injuries. There are many options for the management of duodenal injuries. Herein we are to review our experiences and find out the risk factors related to the morbidity and the mortality in traumatic duodenal injuries. Methods: The medical records of total 25 patients who managed by surgical managements and survive more than 48 hours were conducted from January 2006 to December 2012. The clinical characteristics, treatments, and outcomes are reviewed. Results: Among 25 patients, most of them (n=17, 68.0%) were managed by the pyloric exclusion and the gastrojejunostomy. The $3^{rd}$ portion is the most injured site (n=15, 60.0%), and the majority exhibited grade 2 severity (n=14, 56.0%). Most of patients had blunt abdominal traumas (n=23, 92.0%) so that many of them (n=14, 56.0%) had other combined abdominal injuries. The mean ISS is $11.5{\pm}6.2$. The surgery related mortality rate was 28.0%. There was no statistical significance between each factors and the mortality except leakage (p=0.012). But, we could find some trends about traumatic duodenal injuries in this study. The mortality rates of them who older than 55 years were higher than others. And, all 3 patients who delayed the operation more than 24 hours after the trauma had some complications or died. Also, the patients who had the $2^{nd}$ portion injury, grade 3 injury, or combined abdominal injury were less survived. Conclusion: Duodenal injury is related to high rate of morbidity(47.8%) and mortality(28.0%). Age, portion of injury, OIS grade, ISS>15, combined intra-abdominal operation, and trauma to operation time over 24 hrs have some trend with attribution to mortality. Especially leakage of duodenal injury is related to mortality.

Keywords

References

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