medigraphic.com
SPANISH

Cirujano General

  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Authors instructions        

    • ENVÍO DE ARTÍCULOS

  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2005, Number 3

Cir Gen 2005; 27 (3)

Duodenal lesions (Part II)

Asensio JA, Martín GW, Petrone P, Pardo M, García JC, García NLM, Karsidag T, Kuncir E
Full text How to cite this article

Language: Spanish
References: 19
Page: 245-249
PDF size: 51.90 Kb.


Key words:

Duodenum, duodenal trauma, morbidity, mortality.

ABSTRACT

Objective:To analyze the most relevant aspects of the surgical handling of duodenal injuries.
Setting:Third level health care hospital.
Data collection:By means of MEDLINE, 18 articles related to the subject were chosen.
Selection of studies:We selected those studies dealing with surgical aspects and offering data on morbidity and mortality.
Results:Once the diagnosis has been made, the extent of the injury must be defined and classified according to the AAST-OIS (American Association for Surgery of Trauma and Organs Injury Scale) system; grade III to V injuries are considered complex ones. Seventy-five to eighty-five percent of the duodenal injuries can be repaired with simple surgical techniques. Post-surgical morbidity ranges from 6 to 11% and consists basically in fistulae and duodenal obstruction; other complications are abscesses, pancreatitis, and biliary fistula. Mortality ranges from 5 to 30%, with a mean of 17%, but duodenal injury by itself accounts for 2% of the deaths.
Conclusion:Duodenal trauma is not frequent, although it is associated to a high rate of morbidity and mortality.


REFERENCES

  1. American College of Surgeons, Committee on Trauma. Advanced Trauma Life Support Manual. Chicago, IL, 1997.

  2. Moore EE, Cogbill TH, Malangoni MA, et al. Organ Injury Scaling, In: Pancreas, duodenum, small bowel, colon and rectum. J Trauma 1990; 30: 1427-9.

  3. Carrillo E, Richardson D, Miller F. Evolution in the management of duodenal injuries. J Trauma 1996; 40: 1037-46.

  4. Cogbill TH, Moore EE, Feliciano DV, et al. Conservative management of duodenal trauma: a multicenter perspective. J Trauma 1990; 30: 1469-75.

  5. Deggiannis E, Boffard K. Duodenal injuries. Br J Surg 2000; 87: 1473-9.

  6. Berme C, Donovan A, Hagen W. Combined doudenal pancreatic trauma: the role of end-to-side gastroyeyumostomy. Arch Surg 1968; 96: 712-22.

  7. Buck J, Sorensen V, Fath J, et al. Severe pancreaticoduodenal injuries: the efectiveness of piloric exclusion with vagotomy. Am Surg 1992; 58: 557-61.

  8. Stone H, Garoni W. Experiences in the management of duodenal wounds. South Med J 1966; 59: 864-7.

  9. Asensio J, Demetriades D, Berme J, et al. A unified approach to the surgical exposure of pancreatic and duodenal injuries. Am J Surg 1997; 174: 54-60.

  10. Asensio J, Petrone P, Roldan G, et al. Pancreatoduodenectomy. A rare procedure for the management of complex pancreaticoduodenal injuries. J Am Coll Surg 2003; 197: 937-42.

  11. Asensio J, Rojo E, Petrone P, Karsidag T, Pardo M, et al. Síndrome de exanguinación. Factores predictivos e indicativos para la institución de la cirugía de control de daños. Cir Esp 2003; 73: 120-9.

  12. Ivatury R, Nassoura Z, Simón R, Rodríguez A. Complex duodenal injuries. Surg Clin North Am 1996: 76: 797-812.

  13. Asensio JA, Feliciano D, Delano L, Kerstein M. Management of duodenal injuries. Curr Prob Surg 1993; 11: 1021-100.

  14. Fakhry SM, Watts DD, Luchette FA. EAST Multi-Institutional Hollow Viscus Injury Research Group. Current Diagnostic approaches lack sensitivity in the diagnosis of perforate blunt small bowel injury: analysis from 275,557 trauma admissions from the EAST Multi-Institutional HVI Trial. J Trauma 2003; 54: 295-306.

  15. Asensio J, Stewart B, Demetriades D. Duodenum. In: Ivatury RR, Cayten CG (eds): The Textbook of Penetrating Trauma. p 610. Williams &Wilkins, Ed. Baltimore, MA, 1996.

  16. Levinson M, Peterson S, Sheldon G. Duodenal trauma: experience of a trauma center. J Trauma 1982; 24: 475-80.

  17. Lucas C, Norcross W, Shoemaker W. Traumatic injuries to the duodenum: a report of 98 patients. Ann Surg 1974; 181: 92-8.

  18. Allen G, Frederick M, Cox C, et al. Delayed diagnosis of blunt duodenal injury: an avoidable complication. J Am Coll Surg 1998: 187: 393-9.

  19. Ballard R, Balledino M, Eynon A, et al. Blunt duodenal rupture: A 6-year statewide experience. J Trauma 1997; 43: 229-337.




2020     |     www.medigraphic.com

Mi perfil

CÓMO CITAR (Vancouver)

Cir Gen. 2005;27