[Duodenopancreatic injuries. Apropos of 30 cases].
We present a retrospective study of 30 cases of duodenopancreatic injuries seen between 1985 and 1995. All injuries were due to blunt trauma mostly in traffic accidents. They include 16 duodenal injuries, 7 pancreatic injuries and 7 combined duodenopancreatic trauma. All patient were operated for peritonitis or state of shock. Preoperative diagnosis was evoked in two cases (6%). Isolated duodenal trauma (30%) were treated by primary repair and drainage, while pyloric exclusion was performed for five patients (17%), distal pancreatectomy in one case (3%), duodenojejunostomy with pancreatic jejunostomy in one patient (3%). In three patients (10%) isolated pancreatic trauma were treated by drainage, cystogastrocotomy in two cases (6.6%). There were nine deaths (30%) due to the severity of associated injuries, a false diagnosis, or incomplete initial treatment. Poor outcome was mostly due to delay in the diagnosis and associated intra-abdominal injuries. A precise diagnosis of the duodenopancreatic trauma allows an appropriate therapeutic strategy avoiding subsequent complications.
Errougani
A
A
Service des Urgences Chirurgicales Viscérales (UCV), CHU Avicenne, Rabat, Maroc.
Ameur
A
A
Chkoff
R
R
el Alj
A
A
Balafrej
S
S
D000007:Abdominal Injuries / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D000328:Adult; D003937:Diagnosis, Differential; D004386:Duodenum / Q000293:injuries* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006465:Hemoperitoneum / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D006801:Humans; D007813:Laparotomy; D008297:Male; D010179:Pancreas / Q000293:injuries* / Q000601:surgery; D010538:Peritonitis / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D011183:Postoperative Complications; D011379:Prognosis; D012307:Risk Factors