J Surg Tech Proced | Volume 8, Issue 2 | Case Report | Open Access

Failed Primary Repair of Blunt Duodenal Injury Managed by Tube Duodenostomy, Gastrojejunostomy and a Feeding Jejunostomy: A Case Report

Ntonwetape N, Weledji EP and Mokake DM

1Department of Surgery, University of Buea, S.W. Region, Cameroon 2Regional Hospital Buea, S.W. Region, Cameroon

*Correspondance to: Elroy Patrick Weledji 

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Abstract

Background: The worldwide increase in road traffic crashes and use of firearms has increased the incidence of duodenal injuries. Upper gastrointestinal radiological studies and Computed Tomography (CT) in resource settings may lead to the diagnosis of blunt duodenal injury. Exploratory laparotomy remains the ultimate diagnostic test if a high suspicion of duodenal injury continues in the face of absent or equivocal radiographic signs. Although the majority of duodenal injuries may be managed by simple repair, high-risk duodenal injuries are followed by a high incidence of suture line dehiscence and should be treated by duodenal diversion. Case Report: We report a case of a failed primary repair of a blunt injury to the second part of the Duodenum (D2) in a 24-year-old African man. This was successfully managed by a tube duodenostomy, a bypass gastrojejunostomy and a feeding jejunostomy in a low resource setting. Conclusion: Detailed knowledge of the available operative choices in duodenal injury and their correct application is important. The technique of tube duodenostomy can be successfully applied to cases of large defects in the second part of the Duodenum (D2), failed previous repair attempts and with defects caused by different etiology. It may remain especially useful as a damage control procedure in patients with multiple injuries, significant comorbidities and/or hemodynamic instability.

Keywords:

Duodenum; Blunt injury; Repair; Fistula; Diversion; Tube duodenostomy; Feeding jejunostomy

Citation:

Ntonwetape N, Weledji EP, Mokake DM. Failed Primary Repair of Blunt Duodenal Injury Managed by Tube Duodenostomy, Gastrojejunostomy and a Feeding Jejunostomy: A Case Report. J Surg Tech Proced. 2024; 8(2): 1069..

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