Surgical management of duodenal injuries in children

Alan P. Ladd, Karen W. West, Thomas M. Rouse, L. R. Scherer, Frederick Rescorla, Scott A. Engum, Jay L. Grosfeld

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background. The goal of this study was to review current injury characteristics, severity, intervention, and outcome of duodenal injuries from a single, pediatric trauma facility. Methods. A retrospective review was performed of duodenal injuries in children less than 16 years of age from 1990 to 2000. Results. Twelve children had duodenal injuries as a result of blunt abdominal trauma. Six injuries were the result of motor vehicle crashes. Nonaccidental trauma (2) and contact injury (4) provided the remaining cases. Diagnosis was achieved by abdominal computed tomography. Severity of duodenal injury included grade I (1), II (8), and III (3). Seven patients had associated visceral or neurologic injuries. Average Injury Severity Score was 18. Duodenal repair was required in 9 of the 10 patients explored. Treatment included observation (3); primary repair, alone, (2) or with proximal decompression (4); and pyloric exclusion with gastrojejunostomy (3). Exclusion techniques had fewer complications (0% vs 57%) and fewer hospital days (19 vs 23). Conclusions. Blunt abdominal trauma remains the most prevalent mechanism for pediatric duodenal injuries. Patients undergoing pyloric exclusion for severe duodenal trauma had a lesser morbidity and a shorter hospital stay in this small series. Pyloric exclusion remains an alternative for the treatment of severe duodenal injuries in selected children.

Original languageEnglish
Pages (from-to)748-753
Number of pages6
JournalSurgery
Volume132
Issue number4
DOIs
StatePublished - Oct 1 2002

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Wounds and Injuries
Pediatrics
Nervous System Trauma
Injury Severity Score
Gastric Bypass
Autonomic Nervous System
Motor Vehicles
Decompression
Length of Stay
Tomography
Observation
Morbidity
Therapeutics

ASJC Scopus subject areas

  • Surgery

Cite this

Ladd, A. P., West, K. W., Rouse, T. M., Scherer, L. R., Rescorla, F., Engum, S. A., & Grosfeld, J. L. (2002). Surgical management of duodenal injuries in children. Surgery, 132(4), 748-753. https://doi.org/10.1067/msy.2002.127673

Surgical management of duodenal injuries in children. / Ladd, Alan P.; West, Karen W.; Rouse, Thomas M.; Scherer, L. R.; Rescorla, Frederick; Engum, Scott A.; Grosfeld, Jay L.

In: Surgery, Vol. 132, No. 4, 01.10.2002, p. 748-753.

Research output: Contribution to journalArticle

Ladd, AP, West, KW, Rouse, TM, Scherer, LR, Rescorla, F, Engum, SA & Grosfeld, JL 2002, 'Surgical management of duodenal injuries in children', Surgery, vol. 132, no. 4, pp. 748-753. https://doi.org/10.1067/msy.2002.127673
Ladd AP, West KW, Rouse TM, Scherer LR, Rescorla F, Engum SA et al. Surgical management of duodenal injuries in children. Surgery. 2002 Oct 1;132(4):748-753. https://doi.org/10.1067/msy.2002.127673
Ladd, Alan P. ; West, Karen W. ; Rouse, Thomas M. ; Scherer, L. R. ; Rescorla, Frederick ; Engum, Scott A. ; Grosfeld, Jay L. / Surgical management of duodenal injuries in children. In: Surgery. 2002 ; Vol. 132, No. 4. pp. 748-753.
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