Infectious complications following duodenal and/or pancreatic trauma

Patients with pancreatic and/or duodenal trauma often have a high incidence of infectious complications. In this study we attempt-ed to find the most important risk factors for these infections, A retrospective review of the records of 167 patients seen over 7 years (1989 through 1996) at an urban L evel I trauma center for injury to the duodenum and/or pancreas was perform ed. Fifty-nine patients (35%) had isolated injury to the duodenum (13 blunt , 46 penetrating), 81 (49%) had isolated pancreatic trauma (18 blunt, 63 pe netrating), and 27 (16%) had combined injuries (two blunt, 25 penetrating). The overall mortality rate was 21 per cent and the infectious morbidity ra te was 40 per cent, The majority of patients had primary repair and/or drai nage as treatment of their injuries. Patients with pancreatic injuries (alo ne or combined with a duodenal injury) had a much higher infection rate tha n duodenal injuries, The patients with duodenal injuries had significantly lower penetrating abdominal trauma indices, number of intra-abdominal organ injuries, and incidence of hypothermia. On multivariate analysis independe nt factors associated with infections included hypothermia and the presence of a pancreatic injury. Although injuries to the pancreas and duodenum oft en coexist it is the pancreatic injury that contributes most to the infecti ous morbidity.