26 July 2023
Swift, decisive and comprehensive medical treatment by the General Laparoscopic & Robotics Surgery Department at Fortis Hospital Mohali saved the life of a26-year-old Goa-based man, who had sustained fatal injuries to his duodenum (First part of the small intestine) in a car crash in Himachal Pradesh recently.
Patient Nathan John Menezes was presented to Fortis Mohali in a collapsed state.He had suffered multiple injuries with severe blunt trauma to his abdomen, which caused excruciating and unrelenting abdominal pain along with vomiting. Once he was resuscitated and brought out of shock, the Radiology team accurately diagnosed the injury through an abdominal CT scan, which revealed that the patient had a rare, isolated injury involving the second and the third part of the duodenum with leaking of the gastric juices. Isolated Duodenal trauma is a rare and life-threatening injury as its diagnosis and management poses therapeutic challenges.
Any delay in diagnosis or surgery would have caused further irreversible complications to the patient as the reported morbidity and mortality in such cases is over 40 percent. Following emergent resuscitation by the Triage team, the team ofdoctors led by Dr Atul Joshi, Director Surgeon, Fortis Hospital Mohali, Dr Priti Rabadiya and Dr Pooja Pentam operatedon the patient. Given the complexity of the trauma injury, Prof JD Wig, Head, Department of Surgery, supervised the operation, which lasted for over three hours. Following good rehabilitation at Fortis Mohali, the patient was discharged within a couple of days after the surgery. He has recovered well and is on normal diet.
Shedding light on duodenal injuries, Dr Joshi, said, “Due to the critical location of the duodenum, these injuries can be challenging to identify and require an abdominal CT. Blunt duodenal injury are very uncommon, occurring in about 0.1% of cases and are caused by a blow to the epigastrium (upper middle part of the abdomen) by a narrow object. The line of treatment depends on the location of injury and the amount of tissue destruction. Timely treatment is critical in saving the patient”