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[Duodenal injuries in abdominal trauma].

BACKGROUND
We retrospectively reviewed our patients between 1988 and 1996 with duodenal injuries to demonstrate the diagnostic and therapeutic management.


MATERIAL AND METHODS
The charts of six patients treated in the Division of Traumatology of the University Hospital of Zurich between 1988 and 1996 have been retrospectively reviewed. The mean age was 25 years. In four patients a blunt trauma and in two patients a two gunshot caused the duodenal injury. The injury was classified with the "Duodenum Organ Injury Scale".


RESULTS
The primary repair was successful in three patients, twice a Roux-en-Y duodenojejunostomy with repair of the biliary tract was performed and once a conservative treatment was chosen. No surgery related complications occurred. Two patients died postoperatively because of associated injuries.


CONCLUSIONS
Duodenal injuries are rare and therefore correct diagnosis and treatment is difficult. In case of penetrating trauma or hemodynamic instable patients following blunt trauma the emergent laparotomy is mandatory. CT scan is recommended in cases of hemodynamic stable patients after blunt trauma. Primary repair is the treatment of choice in the majority of duodenal injuries.