POST TRAUMATIC ISOLATED DUODENAL INJURY-A RARITY

Isolated duodenal injury is uncommon with significant mortality (6 to 25) and morbidity(30to 60) because the retroperitoneal situation of most of the duodenum makes rupture difficult to detect. Duodenal injury with leakage of bowel content along with bacterial contamination in retroperitoneum makes repair difficult. Mortality is usually due to the associated organ injuries .Successful surgical repair of a duodenal rupture was first reported in 1896, but it was not until 1905 that the first detailed case report of a survival appeared. Since this time, the number of patients with duodenal injuries increased markedly largely because of increased numbers of automobile accidents and the increased violence on our streets. Thus, physicians treating civilian trauma are being confronted with increasing numbers of duodenal injuries. Surgical management of duodenal injuries as presented in the literature is controversial, if not somewhat contradictory. The experience of most surgeons in this disorder is still limited by its relative infrequency. The surgical literature on duodenal injuries mostly consists of isolated case reports or collective reviews of small series and few authors have had sufficient experience with this injury to develop comprehensive analyses of the problem. Furthermore, many reported series include patients treated by highly variable surgical techniques during the early part of the twentieth century when principles of pre- and postoperative care were poorly developed.