Abstract:
Abstract. Background : The management of duodenal traumas remains controversial. The experience of Ankara
Numune Training and Research Hospital Emergency Surgery Department with duodenal injuries during a 10-year period
was analyzed to identify trends in operative management and sources of duodenum-related morbidity and mortality.
Methods and Results : Between 1994 and 2003, 1799 patients with blunt abdominal trauma were operated on and the
incidence of duodenal trauma was 2.8% (50 patients). The injuries were penetrating in 31 (62%) patients and blunt in
19 (38%). Primary repair (PR) of injury was performed in 24 (48%) patients, primary repair and tube duodenostomy
(PRTd) in 8 (16%) patients, complex repair (CR) in 11 (22%) patients, and exploration only without a duodenal procedure
in 5 (10%) patients. Two of the patients died during laparotomy. The mortality rate was 12% and the incidence of
duodenum-related morbidity was 12%. The overall morbidity rate was 40% (20 patients). The most commonly injured
portion of the duodenum was DII (58%), and the most frequent cause of duodenum-related and overall morbidity in our
series was Grade III duodenal injury.
Conclusion : Our experience suggests that the use of primary repair in grade III injury may be associated with higher
duodenum-related morbidity. Our recommendation is to use complex repair for grade III duodenal injuries.
