@article{ref1,
title="Injuries to the duodenum--prognosis correlates with body Injury Severity Score: a prospective study",
journal="International journal of surgery (London, England)",
year="2007",
author="Rathore, Munir Ahmad and Andrabi, Syed Imran Hussain and Najfi, Syed Muzahir and Chaudhry, Zafarullah and Chaudhry, Abdul Majeed",
volume="5",
number="6",
pages="388-393",
abstract="BACKGROUND: Duodenal injury is an important hollow viscus injury in the abdomen. The study analysed the factors related to the outcome of duodenal injuries presenting to the unit. PATIENTS AND METHODS: Prospectively collected data on a case series involving 23 patients over three years. It involved demographic details, Injury Severity Score, Revised Trauma Score, part of duodenum injured, duodenal injury severity according to the AAST, injury-operation time lag, mode of repair, and the extent of significant associated injuries. Patients with non-perforating injury were excluded. RESULTS: M:F ratio was 9:2. Median age was 33 years. All were operated by a senior registrar or senior. Seven out of 23 were blunt, 13/23 firearm and 3/23 stab injuries. D2 was involved in 87%. Duodenal injury severity was graded according to American Association for Surgery of Trauma-Organ Injury Scale (AAST-OIS). Seventeen/23 were Grade II/III, 3 Grade IV and 3 Grade V injuries. Four had injury-operation lag of >18 h. Two injuries were missed. All injuries up to Grade IV had simple repair. Two of them had T-tube duodenostomy. None had pyloric exclusion. Complex repairs were required for 3/23 patients. Five patients died. Duodenum-related mortality was zero. The mortality was related to body Injury Severity Score >45. One delayed repair developed duodenal fistula. Intra-abdominal abscess, septicaemia and wound dehiscence were seen in two patients each. Adverse prognostic factors towards morbidity was injury-operation lag >18 h.<p /><p>Language: en</p>",
language="en",
issn="1743-9191",
doi="10.1016/j.ijsu.2007.05.006",
url="http://dx.doi.org/10.1016/j.ijsu.2007.05.006"
}