Prognostic factors and management of civilian penetrating duodenal trauma

Objective: This study was designed to investigate risk factors in the final outcome of patients with civilian penetrating abdominal trauma and duodena l injuries, the value of the different surgical approaches used, and to def ine when more complex procedures are indicated, instead of the simple prima ry repair. Methods: The study design was a retrospective review of prospectively colle cted data of a 4-year period (July 1992 to June 1996), Results: A total of 167 patients were admitted with penetrating abdominal t rauma and duodenal injuries at San Juan de Dies Hospital in Santafe de Bogo ta, Colombia, Conclusion: The independent and significant risk factors that determine the severity of duodenal injury and need for complex procedures, as identified in this series, are preoperative or intraoperative shock; Abdominal Trauma Index higher than 25; and associated injuries to the pancreas, superior me sentric vessels, and colon. These factors are associated with an increased incidence of septic complications, duodenal fistula, and late mortality.