Focus on Pancreatic and Duodenal Injuries

Leppäniemi, Ari

doi:10.1007/s00068-007-2004-4

Cited by 5 publications

(5 citation statements)

References 5 publications

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“…20 Numerous surgical procedures have been described with varietal results for the management of the high-output fistulas: triple ostomies, 34,35 various grafts (small bowel, gastric wall, rectus and transversalis muscle), 2,7,36 pyloric exclusion, 37,38 clips, 39 and even radical procedures like Billroth II, Roux-en-Y gastrojejunostomy, Longmire's, and Whipple's. [40][41][42][43] Continuous intraluminal aspiration and infusion with feeding jejunostomy gave good results in the past. 44 Experimental use of expanded polytetrafluoroethylene patch seems promising.…”

Section: Discussionmentioning

confidence: 93%

Biliogastric Diversion for the Management of High-Output Duodenal Fistula: Report of Two Cases and Literature Review

Milias

Deligiannidis

Papavramidis

et al. 2009

Journal of Gastrointestinal Surgery

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High-output duodenal fistula occurs as a result of a duodenal wall defect caused by gastroduodenal surgery, endoscopic sphincterotomy, duodenal injury, and tumors with high morbidity and mortality rate. A new technique for its management is reported along with literature review. This procedure consists of transection of the duodenum 2 cm distally to the pylorus, transection of the common bile duct, and end duodenostomy with or without suturing the duodenal wall defect. The continuity of the alimentary tract is reinstated by an end-to-end duodenojejunostomy, end-to-side choledochojejunostomy, and end-to-side Roux-en-Y jejunojejunostomy, obtaining biliogastric diversion from the duodenum and closure of the fistula. This technique was performed in two patients with excellent results.

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Section: Discussionmentioning

confidence: 93%

Biliogastric Diversion for the Management of High-Output Duodenal Fistula: Report of Two Cases and Literature Review

Milias

Deligiannidis

Papavramidis

et al. 2009

Journal of Gastrointestinal Surgery

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“…Given the subsequent risk of severe complications [25], surgeons should consider the possibility of duodenal injury in hemodynamically stable patients who present with epigastric blunt trauma with a low trauma score. There is no optimal test for diagnosing duodenal injuries, and early diagnosis (which is vital for a positive therapeutic outcome) can be difficult.…”

Section: Discussionmentioning

confidence: 99%

Management of isolated duodenal rupture due to blunt abdominal trauma: case series and literature review

Çelik

Altınlı

Köksal

et al. 2010

Eur J Trauma Emerg Surg

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“…The overall incidence of duodenal injuries in severely injured trauma patients ranges from 0.2-0.6%, and the overall prevalence in those suffering from abdominal trauma ranges from 3-5%1,2 [3,4]. Approximately 80% of these cases are secondary to penetrating trauma, which is commonly associated with vascular and adjacent organ injuries [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Incidence and Management of Duodenal Trauma in a War Setting: Insights from a Military Hospital in Yemen

Obadiel,

Saeed,

Jowah

et al. 2024

Preprint

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Purpose: Duodenal injuries are a significant challenge in war trauma because of their complexity and potential for severe complications. This study evaluated the outcomes of duodenal injury management among patients with war trauma in Yemen, focusing on incidence, severity, surgical approaches, postoperative complications, and factors influencing success or failure. Patients and Methods: A retrospective analysis was conducted on 520 exploratory laparotomy cases from June 2019 to December 2022 at a military hospital in Yemen. Twenty-seven patients with confirmed duodenal injuries were included. Data on demographic characteristics, injury characteristics, surgical management, and outcomes were collected and analyzed. Results: The incidence rate of duodenal injuries was 5.2%. The cohort comprised predominantly young males, with a mean age of 21.93 years. Penetrating trauma accounted for 95.7% of cases. The mean Injury Severity Score (ISS) was 20.63, and most injuries were classified as AAST Grade II. The second duodenum part (D2) was the most commonly affected area. Associated injuries were frequent, particularly colonic (73.9%), chest (39.1%), and liver (29.6%) injuries. Surgical management primarily involved exploratory laparotomy (81.5%) and primary closure (66.7%). Postoperative complications were common, affecting 66.7% of patients, with sepsis (55.6%) being the most common. The success and mortality rates were 81.5%, and the mortality rate was 11.1%. Key risk factors for poor outcomes included higher ISS, grade III injury, damage control surgery, and shrapnel injury. Conclusion: Duodenal injuries in war trauma settings pose significant management challenges, with high rates of associated injuries and postoperative complications. Early diagnosis, appropriate surgical techniques, and vigilant postoperative care is crucial for improved outcomes. Further multicenter research is needed to validate these findings and enhance management strategies in diverse settings.

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Focus on Pancreatic and Duodenal Injuries

Cited by 5 publications

References 5 publications

Biliogastric Diversion for the Management of High-Output Duodenal Fistula: Report of Two Cases and Literature Review

Biliogastric Diversion for the Management of High-Output Duodenal Fistula: Report of Two Cases and Literature Review

Management of isolated duodenal rupture due to blunt abdominal trauma: case series and literature review

Incidence and Management of Duodenal Trauma in a War Setting: Insights from a Military Hospital in Yemen

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