Duodenal injuries: surgical management adapted to circumstances

Jansen, M J C E; Toit, D. F. Du; Warren, Brian

doi:10.1016/s0020-1383(02)00108-0

Cited by 45 publications

(42 citation statements)

References 23 publications

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“…9 They are, primary end-to-end anastomosis or Roux-en-Y duodenojejunostomy with closure of the distal duodenal stump. 10 Considering the procedure of pedicled graft using jejunum as a method of closing large duodenal defects, we decided that the duodenal continuity would be better restored by primary closure in this case.…”

Section: Discussionmentioning

confidence: 99%

Isolated rupture of duodenum following blunt trauma abdomen: report of a case of avulsion of pylorus

et al. 2017

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Isolated duodenal injury following blunt trauma do not occur often. A patient with complete damage to the duodenum presents a challenge to the surgeons. The choice of procedure must be tailored to the nature of the defect and the amount of tissue lost. A 19-years-old male presented with features of bowel perforation following blunt injury abdomen. After initial conservative management, the patient was taken up for laparotomy. A complete transection of duodenum with avulsion of pylorus was found. Primary closure of duodenum and pylorus with omental patch support was done. The patient made an uneventful recovery. The choice of procedure may vary and it depends on the patient condition and surgeon capability. Primary closure of disturbed ends without any gastric diversion procedure is the excellent choice in a young patient with blunt injury without major intraoperative contamination. Primary closure is also a challenging procedure compared to other natural tailoring techniques.

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Section: Discussionmentioning

confidence: 99%

Isolated rupture of duodenum following blunt trauma abdomen: report of a case of avulsion of pylorus

et al. 2017

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“…In cases where the complete pancreaticoduodenal complex is severely damaged, a pancreaticoduodenectomy can be the only option left. However, this therapy has a reported mortality rate of 33% in these patients[ 7, 8]. …”

Section: Discussionmentioning

confidence: 99%

Delayed Closure of Complex Duodenal Injuries by a Foley Balloon Catheter Duodenostomy

Ginhoven

Schepers²,

Obertop³

et al. 2006

Dig Surg

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Less than 5% of abdominal injuries comprise the duodenum. Treatment is complex with high mortality and morbidity rates. These injuries are usually treated surgically and complications frequently occur. Three cases are presented in this communication in which the injury of the duodenum could not be repaired tension-free. In these cases a Foley balloon catheter was used to close the rupture. After a few weeks, patients were fed through the Foley catheter duodenostomy until a fistular track was formed. On removal of the catheter the fistular track closed spontaneously including the perforation of the duodenum.

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“…Frequent complications after duodenal repair include duodenal dehiscence, fistula formation, abscess formation, peritonitis, and sepsis [2,3,8]. Failure of the duodenorrhaphy, resulting in fistula, abscess, and/or sepsis, is the most devastating complication and the major determinant of eventual outcome [2,9]. The therapeutic rationale for pyloric exclusion lies in the diversion of gastric contents, which protects the primary repair and minimizes the aforementioned complications.…”

Section: Discussionmentioning

confidence: 99%

Modified pyloric exclusion for infants with complex duodenal injuries

Harting¹,

Doherty²,

Lally³

et al. 2005

Ped Surgery Int

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Duodenal injuries among infants are exceedingly rare. The use of pyloric exclusion in the treatment of infants is previously unreported. We report three cases of duodenal injury in infants who were surgically managed through duodenal diversion via pyloric exclusion with concomitant tube gastrostomy. A subsequent discussion of pyloric exclusion highlights the therapeutic rationale, surgical technique, and previous experience with this procedure in children.

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Duodenal injuries: surgical management adapted to circumstances

Cited by 45 publications

References 23 publications

Isolated rupture of duodenum following blunt trauma abdomen: report of a case of avulsion of pylorus

Isolated rupture of duodenum following blunt trauma abdomen: report of a case of avulsion of pylorus

Delayed Closure of Complex Duodenal Injuries by a Foley Balloon Catheter Duodenostomy

Modified pyloric exclusion for infants with complex duodenal injuries

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