Delayed Primary Repair of Complex Duodenal Injury Associated to Multiorgan Failure Due to Blunt Abdominal Trauma

Abstract

Duodenal injuries are rare and difficult to diagnose, with an incidence between 1 and 5% in cases of abdominal trauma. We present the case of a 30-year-old man who suffered a motorcycle collision presented with a 24-hour history of abdominal pain, peritoneal tenderness, and hemodynamic instability. Imaging studies show evidence of free fluid in the perihepatic, perisplenic, and pelvic space. An exploratory laparotomy was performed, finding a grade III duodenal, grade V jejunal, and grade II pancreatic injuries. The basis of surgical treatment being a primary anastomosis of duodenal and jejunal injuries, which allowed discharging him home 8 days after surgery and without any complications in his follow-up.

Keywords

• duodenal trauma
• AAST (American Association for the Surgery of Trauma)
• rhabdomyolysis
• hyperkalemia
• anastomosis