Surgical Approaches, Morbidity, and Mortality in Penetrating Duodenal Injuries

Background: For trauma or acute care surgeons, penetrating duodenal injuries can be a challenging case. The ensuing wounds and complications may have disastrous outcomes. Aim of study: To assess the surgical options, morbidity and mortality in penetrating duodenal injuries. Patients and methods: A prospective study conducted in the General Surgery Department in Al-Yarmouk Teaching Hospital during a period of three years from (February 2019 to February 2022). It included 30 patients attended the surgical casualty department and presented with penetrating abdominal injury. Results: The most common cause of injury was gunshot (80%); 50% of injuries were graded II by DIS score; 40% of cases were associated with one organ injury; primary repair was performed in 46.7% of cases; 76.7% of cases didn’t show any complication; and 43.3% were died. Small bowel was the most common associated abdominal organ injury (36.7%); followed by kidney (33.3%). Associated factors with mortality were high severity of injury (PATI Score), injury grade III or more, and in PR, gastrojejunostomy and pyloric exclusion. Conclusion: Primary repair is a viable management option for most duodenal injuries. Because these injuries are highly complex, prompt diagnosis, early surgical intervention, and abbreviated surgical procedures are critical to reducing morbidity and death.