Complete gastroduodenal transaction in a blunt abdominal trauma patient: a rare case report

Authors

  • Vidit Department of General Surgery, PGIMS Rohtak, Haryana, India
  • Hans Raj Ranga Department of General Surgery, PGIMS Rohtak, Haryana, India
  • Sandeep Verma Department of General Surgery, PGIMS Rohtak, Haryana, India
  • Dushyant Yadav Department of General Surgery, PGIMS Rohtak, Haryana, India
  • Mahipal Department of General Surgery, PGIMS Rohtak, Haryana, India
  • Bhavinder Kumar Arora Department of General Surgery, PGIMS Rohtak, Haryana, India

DOI:

https://doi.org/10.18203/2349-2902.isj20233687

Keywords:

Blunt abdominal trauma, Complete gastroduodenal transaction, Bowel injury, Primary repair, Exploratory laparotomy

Abstract

Complete gastroduodenal transaction following blunt abdominal trauma in a road side accident is a rare and potentially life-threatening condition. The course of management and choice of surgical intervention depends on clinical presentation; site, size, nature of defect; amount of tissue and blood loss. In this case report, the clinical presentation, diagnostic evaluation, surgical management and postoperative course of an 18-year adult male patient who presented to the emergency room with complaints of generalized abdominal pain, vomiting and signs of peritonitis following a road side accident suggesting bowel injury. The patient was diagnosed with complete gastroduodenal transaction following blunt abdominal trauma based on radiological imaging and intraoperative findings. The patient underwent emergency laparotomy and primary repair of gastroduodenal transaction with Witzel jejunostomy for better outcome. This case report underscores the early recognition, diagnosis and prompt surgical intervention in cases of complete gastroduodenal transaction following blunt abdominal trauma to achieve favourable patient outcomes.

References

Allen GS, Moore FA, Cox CS Jr, Mehall JR, Duke JH. Delayed diagnosis of blunt injury: an avoidable complication. J Am Coll Surg. 1998;187(4):393-9.

Hughes TMD, Elton C, Hitos K, Perez JV, McDougall PA. Intra-abdominal gastrointestinal tract injuries following blunt trauma: the experience of an Australian trauma centre. Injury. 2002;33:617-26.

Lai CC, Huang HC, Chen RJ. Combined stomach and duodenal perforating injury following blunt abdominal trauma: a case report and literature review. BMC Surg. 2020;20:217.

Ivan Hudson, Thomas G. K. Duodenal transection and vertebral injury occurring in combination in a patient wearing a seat belt.Elseviet. 1988;3(15);6-9.

Kaewlai R, Chatpuwaphat J, Maitriwong W, Wongwaisayawan S, Shin CI, Lee CW. Radiologic Imaging of Traumatic Bowel and Mesenteric Injuries: A Comprehensive Up-to-Date Review. Korean J Radiol. 2023;24(5):406-23.

Kunin JR, Korobkin M, Ellis JH, Francis JR, Kane NM, Siegel SE. Duodena! injuries caused by hunt abdominal trauma: VALUE OF CT in differentiating perforation from hematoma. Am J Roentgenal. 1993;166(8):1221-3.

Harvin JA, Adams SD, Dodwad SM, Isbell KD. Damage control laparotomy in trauma: a pilot randomized controlled trial. The DCL trial. Trauma Surg Acute Care Open. 2021;6(1):e000777.

Hearth,Peter Bautz, Dominic Parker, Christopher D. The importance of wearing a seat belt correctly- A case report of blunt trauma causing complete shearing transection of gastroduodenal junction. IJS Case Rep. 2020;72;197-201.

Telfah MM. Isolated duodenal rupture: primary repair without diversion; is it safe? Review of literature. BMJ Case Rep. 2017;2017:bcr2016215251.

Bhattacharjee HK, Misra MC, Kumar S, Bansal VK. Duodenal perforation following blunt abdominal trauma. J Emerg Trauma Shock. 2011;4(4):514-7.

Donatas V, Saulius B, Kestutis A, Linas U. Witzel Catheter Feeding Jejunostomy: Is It Safe? Dig Surg. 2007;24(5):349-53.

Shah H, Sabbah BN, Elwy BA, Arabi TZ, Sabbah AN, Shah SY. Duodenal transection following a seat belt injury: A case report. Int J Surg Case Rep. 2022;96:107272.

Downloads

Published

2023-11-28

Issue

Section

Case Reports