TRAUMATIC DUODENAL INJURY: A DIAGNOSTIC AND MANAGEMENT DILEMMA

Abstract

Background: Duodenal injuries are challenging and can lead to significant morbidity and mortality
in pediatric patients. The management of these injuries has evolved over the years, and understanding
the nuances of pediatric duodenal injury is crucial for optimizing patient care. The objective of this
study is to understand the nuances of pediatric duodenal injury by evaluating our record of previous
years in our department.
Materials & Methods: A retrospective study was conducted at The Children's Hospital, University
of Child Health Sciences, Lahore, analyzing patient records of traumatic duodenal injuries from April
2017 to November 2019. Data on patient demographics, mode of injury, clinical presentation,
diagnosis, management, complications, and outcomes were collected and reviewed.
Results: Seventeen pediatric patients with traumatic duodenal injuries were included in the study,
with the majority being males presenting with blunt trauma abdomen. Most common presenting
complaints included abdominal discomfort, bilious vomiting, and abdominal distension. Surgical
intervention was pursued for all patients, and associated injuries were observed in 23.5% of patients.
The classification of duodenal injuries varied, with Grade III injuries being the most prevalent.
Postoperative complications and mortality were also noted.
Conclusion
Blunt abdominal trauma, mainly from falls and road traffic accidents, was the most common cause
of pediatric duodenal injuries. Limited access to contrast-enhanced CT highlighted the importance
of clinical assessment and basic imaging in guiding timely intervention, while a multidisciplinary
approach remained crucial for managing severe cases.