ADVANTAGES OF SURGICAL APPROACHES ACCORDING TO THE DEGREE OF INJURY IN DUODENAL TRAUMA
Keywords:
duodenum, trauma, gastroenterostomy, decompression, phlegmon, surgical strategyAbstract
Duodenal injuries, despite being relatively rare in the spectrum of abdominal trauma (0.9–10%), are characterized by diagnostic difficulty, retroperitoneal localization, and a high rate of postoperative complications and mortality.The aim of this study was to evaluate the effectiveness of differentiated surgical strategies based on the degree of duodenal injury.
A retrospective analysis was conducted on the surgical outcomes of 5 patients treated between 2019 and 2025. The severity of injury was assessed according to the E. Moore (1990) classification. In each clinical case, pathogenetically justified surgical approaches were applied, including duodenal decompression, gastroenterostomy, biliary drainage, and enteral nutrition.
The obtained results demonstrated that an individualized surgical strategy based on the severity of injury reduces the risk of postoperative complications, including anastomotic leakage and retroperitoneal phlegmon. In high-grade injuries (IV–V), the use of combined decompressive and diversion procedures is considered a pathogenetically justified approach.
Thus, a differentiated surgical approach in duodenal injuries improves clinical outcomes.
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