The effect of delayed diagnosis on mortality in doudenal injuries

Hasan Calis, Nuraydin Ozlem

Abstract


Duodenal injuries can occur after penetrant or blunt trauma. They are mostly seen after penetrant trauma. Delayed diagnoses of duodenal injuries are often accompanied by morbidity and mortality. In this study, follow-up and examination data from cases with duodenal injuries were evaluated retrospectively. Hospital records of 18 patients with duodenal injury who were followed-up were evaluated. Four patients with missing information related to follow-up and treatment processes were excluded from the study. Thus, 14 patients were included in the study. Of these, 6 patients were injured after penetrant and 8 patients after blunt trauma. One patient with mural hematoma on the first part of duodenum after a blunt trauma was medically followed-up. Sepsis-related late stage mortality was observed in 5 patients. Sepsis-related mortality was observed in 3 patients with delayed diagnosis and examination after getting stabbed. Mortality related to sepsis occurring after suture deficiency on the repair line was observed in one patient with duodenal injury after blunt trauma. Mortality related to sepsis after PTFE graft primary repairment was observed in one patient with iatrogenic duodenal injury. Following the stabilization and resuscitation of the patients after duodenal injuries, if the specialists are not skeptical in the first examination, there is usually a delay in the diagnosis. Early period vital sign and examination findings and radiological evaluations of the patients may not give exact results after trauma. In such a case, repeated examination and radiological evaluations may help. Early stage mortality is usually related to large vessel injuries, however late-stage mortality is related to delayed diagnosis and treatment, sepsis, duodenal fistula, pancreatic and choledochal injuries.


Keywords


Duodenum, injury, trauma, delayed diagnosis, mortality

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References


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