To Observe the Treatment Outcomes of Duodenal Injury in Penetrating and Blunt Trauma Patients

Abstract

Aim: To study about the management of duodenal injury in two clinical aspects, blunt and penetrating injury, along with its complications. Study design: Observational case series. Place and duration of study: Accident & Emergency and General Surgery Departments at M. Islam Teaching Hospital, Gujranwala from March 2019 to March 2020. Methodology: One hundred patients presenting in Accident & Emergency and General Surgical Department of with penetrating chest trauma as diagnosed clinically were included. Routine investigations like complete blood tests, X-rays and special investigations i.e. ultrasound, CT scan were done only in cases where patients were stable. Each hemithorax was divided into medial and lateral hemithorax by an imaginary line drawn longitudinally from clavicle down to the costal margin passing through the nipple. All patients were observed for the type of treatment they were getting i.e. thoracotomy or tube thoracostomy. Patients who were initially treated with tube thoracostomy were cautiously observed for any developing indications for thoracotomy. If such indications arose thoracotomy would be arranged at the earliest possible. Results: A total of 100 patients, 85 (85%) were males and 15 (15%) were females. Male to female ratio was 5.66:1. The mean age of patient was 35.65±9.75 years. There were 38 (38%) had road traffic accidents, 10 (10%) were fall, 7 (7%) injured with fight, 41 (41%) victims of firearm injury and only 4 (4%) victims of stab. The mean blood pressure was 82.15±7.97mmHg. Eighty five (85%) patients were stay in the hospital for 2 weeks and while 15 (15%) were hospital stay >2 weeks. The mean values of hospital stay was 12.45±4.16 days. Conclusion: It is concluded that penetrating thoracic trauma is a major cause of morbidity and mortality. The overall complications rate for blunt trauma injuries after adequate treatment is 18% and mortality rate is 8%. Keywords: Blunt trauma, Thorocotomy, Tube thoracostomy, Pneumothorax