Abstract
Isolated duodenal perforation (IDP) in pediatric trauma is rarely reported. Since most of the children with blunt trauma are managed expectantly, timely diagnosis is imperative to avoid morbidity and mortality. Isolated duodenal injury is an uncommon finding, accounting for about 3 - 5% of abdominal trauma, mainly resulting from both penetrating and blunt trauma and is associated with significant mortality (6 - 25%) and morbidity (30 - 60%)1,2,3.
Keywords: blunt trauma abdomen, duodenal injury.
References
- Biswas S, Butler M, Sherck J. Obstructing intramural duodenal hematoma following relatively minor trauma in a child: A report of a case managed surgically and discussion of relevant treatment options. Int J Surg 2008;17:2.
- Jewett TC Jr, Caldarola V, Karp MP, Allen JE, Cooney DR. Intramural hematoma of the duodenum. Arch Surg 1988;123:54-8.
- Kaufman RA, Towbin R, Babcock DS, Gelfand MJ, Guice KS, Oldham KT, et al. Abdominal upper trauma in children: Imaging evaluation. AJR Am J Roentgenol 1984;142:449-60.
- Celik A, Altinli E, Koksal N, Onur E, Sumer A, Ali Uzun M, et al. Management of isolated duodenal rupture due to blunt abdominal trauma: case series and literature review. Eur J Trauma Emerg Surg. 2010;36:573–8. doi: 10.1007/s00068-010-0055-4.
- Celik A, Altinli E, Ender O, Aziz S, Koksal N. Isolated duodenal rupture due to blunt abdominal trauma. Indian J Crit Care Med. 2006;10:44–6. doi: 10.4103/0972-5229.24690.
- Thomas M, Basu NN, Gulati MS, Seager R, Oke T, Constantinescu G, et al. Isolated duodenal rupture due to go-karting accidents—braking news. Ann R CollSurg Engl. 2009;91:340–3. doi: 10.1308/147870809X400930.
- DuBose JJ, Inaba K, Teixeira PG, Shiflett A, Putty B, Green DJ, et al. Pyloric exclusion in the treatment of severe duodenal injuries: results from the National Trauma Data Bank. Am Surg. 2008;74:925–9.
- Allen GS, Moore FA, Cox CS, Jr, Mehall JR, Duke JH. Delayed diagnosis of blunt duodenal injury: an avoidable complication. J Am Coll Surg. 1998;187:393–9. doi: 10.1016/S1072-7515(98)00205-1.
- Clendenon JN, Meyers RL, Nance ML, Scaife ER. Management of duodenal injuries in children. J Pediatr Surg. 2004;39:964–8. doi: 10.1016/j.jpedsurg.2004.02.032.
- Champion MP, Richards CA, Boddy SA, Ward HC. Duodenal perforation: a diagnostic pitfall in non-accidental injury. Arch Dis Child. 2002;87:432–3. doi: 10.1136/adc.87.5.432.
- Huntimer CM, Muret-Wagstaff S, Leland NL. Can falls on stairs result in small intestine perforations? Pediatrics. 2000; 106:301–5. doi: 10.1542/peds.106.2.301.
- Degiannis E, Boffard K. Duodenal injuries. Br J Surg. 2000;87:1473–9. doi: 10.1046/j.1365-2168.2000.01594.x.
- Torba M, Gjata A, Buci S, Troci A, Subashi K. Delayed presentation of blunt duodenal injuries in children. Case report and review of literature. G Chir. 2013;34:122–4.
- Bhattacharjee HK, Misra MC, Kumar S, Bansal VK. Duodenal perforation following blunt abdominal trauma. J Emerg Trauma Shock. 2011;4:514–7.
- Linsenmaier U, Wirth S, Reiser M, Körner M. Diagnosis and classification of pancreatic and duodenal injuries in emergency radiology. Radiographics. 2008;28:1591–602. doi: 10.1148/rg.286085524.
- Toxopeus MD, Lucas CE, Krabbenhoft KL. Roentgenographic diagnosis in blunt retroperitoneal duodenal rupture. Am J Roentgenol Radium TherNucl Med. 1972;115:281–8. doi: 10.2214/ajr.115.2.281.
- Malhotra AK, Fabian TC, Katsis SB, Gavant ML, Croce MA. Blunt bowel and mesenteric injuries: the role of screening computed tomography. J Trauma. 2000;48:991–8. doi: 10.1097/00005373-200006000-00001.
- Elnemr A. Comparison of various techniques for repair of large duodenal wall defects: an experimental study. Ann Pediatr Surg. 2006;2:139–50.
Corresponding Author
Dr Alok Mazumdar
DOI: https://dx.doi.org/10.18535/jmscr/v7i3.85
