Blunt Traumatic Transection of the Duodenal Bulb Reconstructed with Gastroduodenostomy Using an Automatic Anastomotic Device in a Child

Abstract

Blunt duodenal injury is relatively rare, with few reports of pediatric cases. Many surgical options have been discussed as the injury has high complication and mortality rates. We report a 12-year-old child with complete transection of the duodenal bulb, and successful repair with side-to-end gastroduodenostomy using an automatic anastomotic device. The child was transferred to our hospital complaining of abdominal pain after being involved in a motor vehicle accident. He was a back-seat passenger wearing a seat belt. Abdominal computed tomography showed free air around the liver, with contrast extravasation in a hematoma around the duodenum. Emergency surgery revealed complete transection of the duodenal bulb. Gastroduodenal side-to-end anastomosis was performed using a circular stapling autosuture device. He was discharged from the hospital without complications on the 15th day. Blunt duodenal injury may result in severe outcomes. This patient successfully underwent reconstruction of a physiologically normal route using an autosuture device. This reconstruction method has apparently not been reported, but may be safe in selected patients with complete transection of the duodenal bulb.