POST TRAUMATIC ISOLATED DUODENAL INJURY-A RARITY

Abstract

Abstract : Isolated duodenal injury is uncommon with
significant mortality (6 to 25) and morbidity(30to 60) because
the retroperitoneal situation of most of the duodenum makes
rupture difficult to detect. Duodenal injury with leakage of
bowel content along with bacterial contamination in
retroperitoneum makes repair difficult. Mortality is usually due
to the associated organ injuries .Successful surgical repair of
a duodenal rupture was first reported in 1896, but it was not
until 1905 that the first detailed case report of a survival
appeared. Since this time, the number of patients with
duodenal injuries increased markedly largely because of
increased numbers of automobile accidents and the
increased violence on our streets. Thus, physicians treating
civilian trauma are being confronted with increasing numbers
of duodenal injuries. Surgical management of duodenal
injuries as presented in the literature is controversial, if not
somewhat contradictory. The experience of most surgeons in
this disorder is still limited by its relative infrequency. The
surgical literature on duodenal injuries mostly consists of
isolated case reports or collective reviews of small series and
few authors have had sufficient experience with this injury to
develop comprehensive analyses of the problem.
Furthermore, many reported series include patients treated by
highly variable surgical techniques during the early part of the
twentieth century when principles of pre- and postoperative
care were poorly developed.