ArticleAnnals of medicine and surgery (2012)2026
Pediatric blunt duodenal injury: a 9-year retrospective single-center series from Vietnam.
Article in Annals of medicine and surgery (2012), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Pediatric duodenal injury is uncommon, often presents with non-specific features, and is frequently recognized late. Objective: To describe injury patterns, diagnostic imaging, operative strategies (including decompression approaches), and outcomes in children with blunt duodenal injuries. Methods: We conducted a retrospective study of consecutive patients aged ≤18 years with blunt abdominal trauma and confirmed duodenal injury treated at a tertiary pediatric hospital in Vietnam (October 2015-May 2024). Demographics, injury characteristics (American Association for the Surgery of Trauma [AAST] grade), imaging findings, management (non-operative vs. operative), decompression approaches, complications, and length of stay (LOS) were extracted from medical records and summarized descriptively. Results: Fourteen patients were included (mean age 8.8 years). AAST grades I-IV were [3/14 (21.4%)], [6/14 (42.9%)], [4/14 (28.6%)], and [1/14 (7.1%)], respectively. Computed tomography (available in 10/14) frequently demonstrated free intraperitoneal fluid ([10/10, 100%]) and, less commonly, duodenal wall discontinuity ([2/10, 20%]). Non-operative management was used in hematoma-dominant injuries ([3/14, 21.4%]). Surgery was performed in [11/14, 78.6%], most commonly primary repair ([6/11]) or Roux-en-Y duodenojejunostomy ([2/11]). Systematic decompression was applied in all cases: nasogastric tube alone (6/14), nasogastric plus feeding jejunostomy (4/14), nasogastric plus retrograde jejunostomy (1/14), or triple-tube decompression (3/14). Postoperative complications occurred in 7/11 (63.6%, 95% CI: 30.8-89.1%) of surgically managed patients; there were no deaths. Median hospital LOS was 27 days (range 3-92). Conclusions: Pediatric blunt duodenal injury should be suspected in children with non-specific abdominal symptoms after blunt trauma. In this series, CT-based assessment and tailored management with decompression were feasible and associated with recovery in all patients.
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