DUODENO-PANCREATIC TRAUMA - A SERIES OF 3 0 CASES

We present a retrospective study of 30 cases of duodenopancreatic inju ries seen between 1985 and 1995. All injuries were dire to blunt traum a mostly in traffic accidents. They include 16 duodenal injuries, 7 pa ncreatic injuries and 7 combined duodenopancreatic trauma. All patient were operated for pel peritonitis or state of shock. Preoperative dia gnosis was evoked in two cases (6 %). Isolated duodenal trauma (30 %) were treated by primary repair and drainage, while pyloric exclusion w as performed for five patients (17 %), distal pancreatectomy in one ca se (3 %), duodenojejunostomy with pancreatic jejunostomy in one patien t (3 %). In three patients (10 %) isolated pancreatic trauma were trea ted by drainage, cystogastroctomy in two cases (6,6 %). There were nin e deaths (30 %) due to the severity of associated injuries, a false di agnosis, or incomplete initial fl treatment. Poor outcome was mostly d ue to delay in the diagnosis and associated intra-abdominal injuries. A precise diagnosis of the duodenopancreatic trauma allows an appropri ate therapeutic strategy avoiding subsequent complications.