Complex repair for the management of duodenal injuries

George C. Velmahos, Eman Kamel, Linda S. Chan, David Hanpeter, Juan A. Asensio, James A. Murray, Thomas V. Berne, Demetrios Demetriades

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

The management of duodenal injuries is a subject of ongoing debate. In this study we attempt to describe duodenum-related morbidity (DRM) after primary repair or complex repair (CR) and to identify risk factors for development of complications. The medical records of 145 consecutive patients admitted to Los Angeles County+University of Southern California Medical Center with duodenal injuries between January 1991 and December 1997 were reviewed. Fifty-four (37%) died within 24 hours of admission because of associated injuries. The remaining 91 were subjected to univariate and multivariate analysis. Of them, 66 (72.5%) developed complications and 3 (3%) died. CR was used in 32 (35%) patients and with increasing frequency as the grade of duodenal injury increased. DRM rate was overall low (9%) and not different between low-grade and high-grade duodenal injuries. This occurred despite a significant increase in Injury Severity Score and abdominal Abbreviated Injury Score in patients with more severe duodenal injuries. Patients with overall complications had higher Injury Severity Scores, higher abdominal Abbreviated Injury Scores, and more severe duodenal injuries. We conclude that duodenal injuries are frequently associated with other highly lethal injuries. Liberal use of CR in patients with more severe duodenal injuries prevents DRM.

Original languageEnglish
Pages (from-to)972-975
Number of pages4
JournalAmerican Surgeon
Volume65
Issue number10
StatePublished - Oct 1999
Externally publishedYes

Fingerprint

Wounds and Injuries
Duodenum
Abdominal Injuries
Injury Severity Score
Morbidity
Los Angeles
Medical Records
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Velmahos, G. C., Kamel, E., Chan, L. S., Hanpeter, D., Asensio, J. A., Murray, J. A., ... Demetriades, D. (1999). Complex repair for the management of duodenal injuries. American Surgeon, 65(10), 972-975.

Complex repair for the management of duodenal injuries. / Velmahos, George C.; Kamel, Eman; Chan, Linda S.; Hanpeter, David; Asensio, Juan A.; Murray, James A.; Berne, Thomas V.; Demetriades, Demetrios.

In: American Surgeon, Vol. 65, No. 10, 10.1999, p. 972-975.

Research output: Contribution to journalArticle

Velmahos, GC, Kamel, E, Chan, LS, Hanpeter, D, Asensio, JA, Murray, JA, Berne, TV & Demetriades, D 1999, 'Complex repair for the management of duodenal injuries', American Surgeon, vol. 65, no. 10, pp. 972-975.
Velmahos GC, Kamel E, Chan LS, Hanpeter D, Asensio JA, Murray JA et al. Complex repair for the management of duodenal injuries. American Surgeon. 1999 Oct;65(10):972-975.
Velmahos, George C. ; Kamel, Eman ; Chan, Linda S. ; Hanpeter, David ; Asensio, Juan A. ; Murray, James A. ; Berne, Thomas V. ; Demetriades, Demetrios. / Complex repair for the management of duodenal injuries. In: American Surgeon. 1999 ; Vol. 65, No. 10. pp. 972-975.
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