Paediatric Duodenal Injury Following Trivial Abdominal Trauma.

Isolated duodenal injury following blunt abdominal trauma (BAT) is relatively rare. The incidence of duodenal injuries is 11.2-26% due to blunt trauma. The choice of treatment must be tailored to the nature of the defect and the amount of tissue lost. We present a series of three cases of duodenal injury due to trivial trauma of which two cases of duodenal perforation were treated surgically and one was a duodenal hematoma managed conservatively. Varieties of surgical techniques have been described for the management of patients with duodenal injuries. The surgeon should select the most appropriate procedure based on the type and conditions of the duodenal injury. CECTscan of abdomen remains valuable tool in children with BATfor diagnosis and further management.

Analysis of High-risk Factors of Iatrogenic Duodenal Injuries and Surgical Tactics of Treatnent According to Injuries Scaling / 医学研究杂志

Objective To sum up and discern the high risk factors of iatrogenic duodenl injuries and to evaluate the value of the treatment according to the new trauma scaling,so as to to facilitate and guide clinical research.Methods 21 patients with iatrogenic duodenal trauma hospitalized and From Jan.1985 to Oct.2005,in our hospital were collected and retrospectively reviewed,the duodenum organ iatrogenic injury scale was classified and developed depending on the clinical finding and referring to the injury scale by the American Association for the Surgery of Trauma(A.A.S.T.)in 1990.Results The iatrogenic duodenal injuries result from various surgery and endoscopic procedures,most from a sequelae to pertinent biliary operation and(or)iatrogenic technical errors of instrumention.High risk factors responsible for the iatrogenic injuries include inflammatory conglutination,biliary systems anomalies or anatomic variations,duodenal Vater's papilla with neoplasma or diverticulum,surgeohs with less experience or over self-confidence or some procedures with violence and specific correctable errors,and so on.According to the new grading scheme,the duodenal injuries of the 21 cases were classified as follows:grade I-5 cases,grade II-6 cases,grade III-5 cases,grade IV-3 cases,and grade V-2 cases.Among the patients,3 cases were treated by drainage.2 cases underwent simple repair.8 cases were treated with repair and drainage.8 cases underwent enterorrhaphy and drainage.Conclusions Knowledge about causal factors of such iatrogenic processes can play a crucial role in their prevention,correct diagnosis,and management.Having the iatrogenic duodenal scaling done well,appears to be an accurate and practical way to select an optimum and flexible treatment and improve the patients's prognosis.