Abstract
IntroductionBlunt duodenal injuries do not occur often. A patient with damage to the duodenal tissue around the pancreatic and common bile duct presents a challenge to surgeons. The choice of procedure must be tailored to the nature of the defect and the amount of tissue lost.Case presentationWe describe the case of a 16-year-old Caucasian boy with a blunt duodenal injury after a motor vehicle accident. On admission, the patient had stable vital signs and a normal laboratory workup. Gradually his clinical condition deteriorated and a computed tomography scan showed a retroperitoneal haematoma at the level of his duodenum. A fully circumferential rupture of the second part of his duodenum was found during laparotomy, with the intact Vater's papilla lying adjacent to the defect and a superficial laceration of the head of his pancreas. The retroperitoneal haematoma was thoroughly drained and a pedicled ileal loop was interposed between the duodenal stumps to restore the continuity of the patient's duodenum. Apart from a mild postoperative pancreatitis, the patient's postoperative course evolved with no further problems. The patient was discharged on the 22nd postoperative day in excellent condition and has remained so to date (after five years).ConclusionIn our case report, where the second part of the patient's duodenum was completely transected, our choices for reconstruction were limited. Important factors for the successful management of this patient were prompt surgical intervention and the accurate assessment of the nature of the duodenal and associated injuries. We believe that the technique we used was a reasonable choice because the anatomical continuity of the patient's duodenum was restored.
Highlights
Blunt duodenal injuries do not occur often
Patients with duodenal injuries represent approximately 4% of all patients with abdominal injuries from blunt trauma, usually resulting from motor vehicle accidents, which account for 22% of all patients with duodenal injuries [1]
Due to the anatomical position of the duodenum, blunt duodenal trauma is usually associated with injuries to adjacent structures, including the pancreas, bile duct, mesenteric vessels, and inferior vena cava [1]
Summary
In our case report, where the second part of the patient’s duodenum was completely transected, our choices for reconstruction were limited. We believe that the technique we used was a reasonable choice because the anatomical continuity of the patient’s duodenum was restored
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