Alternativa quirúrgica de reparación duodenal en pediatría (presentación de caso), Hospital Infantil Dr. Robert Reid Cabral (HIRRC), República Dominicana

Introduction: Blunt trauma of the abdomen in pediatrics causes injury to abdominal organs in 8-12 % of the population, with duodenal injuries being only 10 % of these, which is why they are rare in pediatrics. The main cause of duodenal injury is related to childhood abuse, with motor vehicle accidents being the second most common mechanism. When it comes to nondestructive injury, primary duodenal repair is reasonable. However, destructive injuries warrant more complex repair strategies. Material and Method: We present a 3-year-old male patient with a grade III duodenal injury at the duodenojejunal angle, which was initially operated on by means of a primary anastomosis, with subsequent dehiscence. In his second operation, a distal duodenal closure and a gastrojejunal anastomosis were performed, favoring retrograde flow of the bile ducts to the stomach, with adequate evolution. Conclusion: There are multiple surgical approaches, which still represent great morbidity today. Duodenal closure with the subsequent decision on how to bypass the bile ducts is probably the greatest challenge. The possibility of duodenal closure distal to the bile ducts, with retrograde drainage, is raised. Therefore, gastrojejunostomy is an alternative technique in pediatrics for the repair of complex duodenal injuries.