title: Diagnosis and Treatment of Duodenal Injury: A Clinical Analysis.
abstract: OBJECTIVE
  Duodenal injuries do not often occur and are usually difficult to be diagnosed or treated.
  
  
  METHODS
  To summarize the experience in managing duodenal injuries and determine some prognostic factors, we conducted a retrospective review on 42 cases of duodenal injuries including 17 traumatic (blunt 31.0%, penetrating 9.5%) and 25 iatrogenic (59.5%) ones, which were admitted to our hospital from 1993 to 2013.
  
  
  RESULTS
  The mortality rate was 23.8% (n = 10). Main cause of late death was multiple system organ failure and infection. Senility and high APACHE II score were both correlated with mortality rate (P < 0.01 and P < 0.05 respectively). High morbidity and mortality rate were more likely to be associated with those had long delays in treatment or injury in the second part of the duodenum (P < 0.05). The number of associated injuries affected mortality rate (P < 0.05). For traumatic injuries, the mechanism of injury, method of initial surgical management, Organ Injury Scale and Abbreviated Injury Scale were not related to patients' outcome (P > 0.05).
  
  
  CONCLUSIONS
  These findings indicated that early diagnosis and timely treatment were of great clinical value. Primary repair with an effective diversion was practicable. Age and APACHE II Score were the independent prognostic factors.
authors.forename: Jun
authors.initials: J
authors.lastname: Hong
authors.forename: Shu-Yan
authors.initials: SY
authors.lastname: Wang
authors.forename: Li
authors.initials: L
authors.lastname: Qian
authors.forename: Zong-you
authors.initials: ZY
authors.lastname: Chen
mesh_terms: D018806:APACHE; D000007:Abdominal Injuries / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D000367:Age Factors; D000368:Aged; D002681:China; D004386:Duodenum / Q000293:injuries / Q000601:surgery*; D042241:Early Diagnosis; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D061665:Time-to-Treatment; D014949:Wounds, Nonpenetrating / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D014950:Wounds, Penetrating / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000601:surgery*