Blunt duodenal injuries in children

Ketan M. Desai, Ian G. Dorward, Robert K. Minkes, Patrick A. Dillon, Henri Ford

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Background: Duodenal injury secondary to blunt trauma continues to pose a diagnostic challenge. The purpose of this study is to evaluate the cause, radiologic findings, and management of duodenal injuries from a Level I pediatric trauma center. Methods. A retrospective review of our trauma registry from 1990 to 2000 identified 24 children with blunt duodenal injuries. Clinical and radiographic findings and management strategies were assessed and compared in children with duodenal hematomas and perforations. Results: The majority of injuries were secondary to motor vehicle collisions. Pancreatic (42%) injuries were most commonly associated with duodenal trauma. With the exception of hematocrit level, initial clinical and laboratory findings were similar between groups. Of the 19 (79%) with duodenal hematomas, computed tomographic (CT) scan alone identified 15 and the remaining 4 were confirmed by duodenography. Incision and drainage of a hematoma was performed in two children. Duodenal perforation was identified in five (21%) children. Extraluminal air by CT scan was present in three of five children with perforation; however, none had extravasation of contrast. Four (80%) children with perforations underwent primary repair and one (20%) required segmental resection. Conclusion. CT scanning remains a valuable tool in the diagnosis of blunt duodenal injuries in children. Although extravasation of oral contrast was not beneficial, the presence of extraluminal air was highly suggestive of perforation. The vast majority of hematomas were successfully managed nonoperatively, and duodenorrhaphy was safe and effective therapy for perforations.

Original languageEnglish (US)
Pages (from-to)640-646
Number of pages7
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume54
Issue number4
DOIs
StatePublished - Apr 1 2003

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Nonpenetrating Wounds
Wounds and Injuries
Hematoma
Air
Trauma Centers
Motor Vehicles
Hematocrit
Registries
Drainage
Pediatrics

Keywords

  • Blunt
  • Children
  • Duodenal
  • Injury

ASJC Scopus subject areas

  • Surgery

Cite this

Blunt duodenal injuries in children. / Desai, Ketan M.; Dorward, Ian G.; Minkes, Robert K.; Dillon, Patrick A.; Ford, Henri.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 54, No. 4, 01.04.2003, p. 640-646.

Research output: Contribution to journalArticle

Desai, Ketan M. ; Dorward, Ian G. ; Minkes, Robert K. ; Dillon, Patrick A. ; Ford, Henri. / Blunt duodenal injuries in children. In: Journal of Trauma - Injury, Infection and Critical Care. 2003 ; Vol. 54, No. 4. pp. 640-646.
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