RESEARCH ARTICLE


Diverticulization Duodenal Distal Technique for Injury Angle Duodenojejunal



Luis R. Martinez, Pablo Valsangiacomo*, Gabriela Espinosa, Gabriela Wagner, Roberto Taruselli
Department of General Surgery, Maciel Hospital, Montevideo, Uruguay


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© Martinez et al.; Licensee Bentham Open

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of General Surgery, Maciel Hospital, Montevideo, Uruguay; Tel: (598) 29153000; E-mail; pvalsangiacomo@yahoo.es


Abstract

Duodenojejunal injuries region at the angle of Treitz are rare, variable etiology and often associated with other serious injuries. In trauma situations with perforations and bleeding, his approach is often difficult. The primary suture, resection / anastomosis and duodenal exclusion are the usual for trauma management techniques in this region. The aim of this paper is to show the initial results of an alternative for injuries duodenojejunal angle (IDJA) by filling a retrospective, descriptive and observational technique, 12 patients operated were analyzed over a period of 15 years, carriers IDJA, age: 34, 11 gunshot wound. 92% of the cases had other associated visceral injuries. The average for the ISS was 29. In all cases located in duodenum duodenojejunoanastomosis II, via the right lateromesenterica upon closing section and duodenum level III was performed. 58% of cases were complicated. Mortality case series were 1 (8%) digestive suture failure colon. Average Hospital stay 26 days.

Conclusion:

A simple, safe and maintaining gut physiology is proposed technique; with a single anastomosis, located in well-vascularized area and away from bruising and contaminated areas. The complications were pancreatic fistula and digestive suture failure.

Keywords: Duodenal injuries, Duodenal diverticulizacion, Treitz, Vascularization.