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  • Title: [Injuries of the duodenum].
    Author: Novikov AS, Urakcheev ShK, Bogdanov SV.
    Journal: Vestn Khir Im I I Grek; 1998; 157(6):49-53. PubMed ID: 10672662.
    Abstract:
    During 10 years there were 94 patients aged 16-68 years with injuries of the duodenum. Their case histories were studied in order to establish the causes of complications and lethality. Among them there were 48 patients with knife wounds, 5 patients with gunshot wounds, closed trauma of the abdomen was diagnosed in 40 patients, 1 patient had a iatrogenic wound of the duodenum. There were 17 isolated injuries of the gut and 77 combined and multiple injuries. Patients with traumatic perforations in the duodenum made up 89.4%, 31% of them died. In 70 patients suture of the duodenum was put during operation, 10 patients had sutures and intubation of the duodenum, in 6 patients the injured gut was excluded, in 1 patient resection of the duodenum was made and primary anastomosis was formed. 28 patients (29.8%) died. Among the causes of the deaths were non-compensated blood loss resulting from hemorrhage from the vessels of the liver and other organs, combined and multiple injuries. Pyo-septic complications led to death of 12 patients, duodenal fistula was found in 4 patients. An analysis of the material has shown that most patients with traumas of the duodenum could be cured by suturing the incised or lacerated wound of the duodenum. Exclusion of the duodenum is thought to be a helpful addition to operation on the injured duodenum, especially on large wounds. Pancreatoduodenectomy is necessary but seldom in surgery of such traumas.
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