526
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Sinev IV, Luzhnikov EA, Volotskov VI, Lukash IL. [Esophagogastroduodenoscopy in chemical injuries of the upper part of the gastrointestinal tract]. Khirurgiia (Mosk) 1987:29-35. [PMID: 3437690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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527
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Ng KW, Jiang CF, Wang CC. [Intramural hematoma of the duodenum following car accident--case report]. ZHONGHUA YI XUE ZA ZHI = CHINESE MEDICAL JOURNAL; FREE CHINA ED 1987; 40:481-4. [PMID: 3509717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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528
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Abstract
Fifteen cases of duodenal trauma that presented to Westmead Hospital between 1979 and July 1986 are reviewed. There were 12 blunt injuries, nine caused by motor vehicle accidents. Three patients sustained penetrating injuries, two due to stab wounds. Repair for blunt laceration or incised wound was by primary closure or serosal patch repair, most often with decompressive t-tube duodenostomy. No leak from the duodenal repair occurred in any patient. Two patients died. This was not due to complications of the duodenal injury. Pyloric exclusion, duodenal diverticulization or pancreaticoduodenectomy was not considered necessary in any patient. Morbidity of duodenal haematoma in the form of continuing abdominal pain may be avoided by intra-operative drainage.
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529
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Gonzalez R, Heiss WH, Rauh W. [Blunt abdominal trauma caused by child abuse]. Monatsschr Kinderheilkd 1987; 135:692-5. [PMID: 3683408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
We report about 3 boys under 4 years of age with abdominal blunt trauma following child abuse admitted to our clinic with different diagnoses. Common were fresh or older haematomas, burn wounds, for which the parents had no plausible explanation. The children had no skeletal or intracranial lesions, but they developed abdominal pain, which became worse in the absence of the parents. X-ray and the clinical course lead us to laparatomy. In all cases we found lesions of the intestines, especially near the duodenojejunal flexure, hepatoduodenal ligament, root of the mesentery, mesocolon and retroperitoneum, in one case a pancrease rupture. All these lesions were caused by child abuse. We want to point out the problem in the diagnosis of battered child syndrome, especially of the abdominal blunt trauma.
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530
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Zaouche A, Belkhodja C, Khereddine T, Horchani H, Bouchoucha S, Ennabli E. [Diagnosis and treatment of duodenal-pancreatic injuries. Apropos of 26 cases]. LA TUNISIE MEDICALE 1987; 65:525-32. [PMID: 3333120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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531
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Gabry AL, Zdonowski P, Richardot R, Lepert R. [Duodenal fistula. Treatment with small doses of somatostatin]. Presse Med 1987; 16:1288. [PMID: 2885830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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532
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Abstract
The records of 115 patients with a duodenal injury have been reviewed. The majority of the patients (83 percent) were treated with primary repair of the injury. Twelve patients underwent duodenal diverticulization. The mortality rate in all 115 patients was 12 percent, in 105 patients who survived more than 48 hours 4 percent, and in 26 patients with pancreaticoduodenal injury 15 percent. Vascular injury was the major cause of early death. Enteric perforations were present in 75 percent of the patients with sepsis. The majority of patients with associated pancreatic injury had primary repair and did not have pancreaticoduodenal complications. Duodenal fistula continues to be a serious postoperative complication. Primary repair with drainage is the preferred treatment. Gastrostomy and feeding jejunostomy are useful adjuncts. A more complex operation should be reserved for a highly select group of patients with severe duodenal injury.
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533
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Evdokimov VN, Beresneva EA, Vladimirova ES. [X-ray diagnosis of duodenal rupture in closed abdominal trauma]. VESTNIK RENTGENOLOGII I RADIOLOGII 1987:21-6. [PMID: 3672878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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534
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Feliciano DV, Martin TD, Cruse PA, Graham JM, Burch JM, Mattox KL, Bitondo CG, Jordan GL. Management of combined pancreatoduodenal injuries. Ann Surg 1987; 205:673-80. [PMID: 3592810 PMCID: PMC1493060 DOI: 10.1097/00000658-198706000-00009] [Citation(s) in RCA: 114] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
From 1969 to 1985, 129 patients with combined pancreatoduodenal injuries were treated at one urban trauma center. A total of 104 patients (80.6%) had penetrating wounds, and multiple visceral and vascular injuries were usually associated with the pancreatoduodenal injury. Primary repair or resection of one or both organs coupled with pyloric exclusion and gastrojejunostomy (68 patients) and drainage was used in 79 patients (61.2%) in the entire study and in 59% (36 of 61) of all patients treated since 1976. Simple primary repair of one or both organs and drainage was performed in 31 patients (24%), whereas the remaining 19 patients (14.8%) had pancreatoduodenectomies (13 patients) or no repair before exsanguination (six patients). Major pancreatoduodenal complications occurring in the 108 patients surviving more than 48 hours included pancreatic fistulas (25.9%), intra-abdominal abscess formation (16.6%), and duodenal fistulas (6.5%). The overall mortality rate for the study was 29.5% (38 of 129). The acute mortality rate with these injuries will remain high secondary to injuries to associated organs and vascular structures. The morbidity and late mortality rates related to the moderate to severe pancreatoduodenal injury itself can be decreased by the addition of pyloric exclusion and gastrojejunostomy to the primary repairs.
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535
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Weese JL, Wissler DW, Magary JA, Ramirez G. Endoscopic transduodenal removal of an hepatic artery infusion catheter. Gastrointest Endosc 1987; 33:246-7. [PMID: 3596193 DOI: 10.1016/s0016-5107(87)71572-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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536
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537
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Grindlinger GA, Vester SR. Transvaginal injury of the duodenum, diaphragm, and lung. THE JOURNAL OF TRAUMA 1987; 27:575-6. [PMID: 3573118 DOI: 10.1097/00005373-198705000-00022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
An unusual case of transvaginal impalement is presented. At initial exploration the broad ligament and vagina were repaired. When bile drained from suction catheters reexploration revealed an injury to the duodenum and diaphragm. Wounds that penetrate the vagina may injure nonpelvic viscera. Vaginal penetrating wounds should be managed like other abdominal penetrating injuries.
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538
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Calen S, Moreno P, Nicolau H, Winnock S, Janvier G, Videau J. [Duodenopancreatic injuries. Diagnostic and therapeutic considerations apropos of 25 cases]. JOURNAL DE CHIRURGIE 1987; 124:263-71. [PMID: 3584288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
A review of a homogeneous series of 25 cases of duodenopancreatic injuries emphasizes the serious nature of the lesions operated upon at the acute pancreatitis stage. An early diagnosis of these duodenopancreatic lesions is essential since they are often included in the context of multiple injuries. Principal diagnostic difficulties arise in lesions due to contusion without associated intra-abdominal injuries. In these cases ultrasound and CT scan imaging provide valuable data, particularly the latter exploration which is 89% reliable in demonstrating pancreatic morphology. Treatment differs as a function of presence of isolated or combined duodenal and pancreatic lesions and of lesional type. It should be as conservative as possible, although exeresis for lesions of body and tail of pancreas is currently performed more frequently.
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539
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Melissas J, Baart GD, Mannell A. Pancreaticoduodenectomy for pancreatic trauma. A case report. S Afr Med J 1987; 71:323-4. [PMID: 3563759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Pancreatic trauma is uncommon and severe, combined pancreaticoduodenal injuries are rare. Different surgical techniques for the management of these injuries have been used. In this article a case of severe pancreaticoduodenal injury which required pancreaticoduodenectomy is reported. This case is unusual because there was no history of trauma, the serum amylase level and abdominal radiograph were normal and the abdominal findings on admission to hospital were minimal. A system of grading pancreatic trauma in terms of severity is advocated and the management of pancreaticoduodenal injuries is discussed.
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540
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Whalen GF, Robbs JV, Baker LW. Injuries of the pancreas and duodenum--results of a conservative approach. S AFR J SURG 1987; 25:15-8. [PMID: 3563731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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541
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Abstract
The treatment of 484 adults with caustic ingestion injury is discussed. Signs and symptoms are an unreliable guide to injury and a chest X-ray and fibreoptic endoscopy should be performed as soon as possible. All of the 250 patients who developed superficial lesions of the oesophagus, stomach or duodenum experienced healing without sequelae. Forty-four patients required emergency surgery of whom twenty-four died and oesophagectomy without thoracotomy is now advocated for this group, followed by interval surgery to restore continuity. The remaining 190 patients suffered gastric or oesophageal ulceration without necrosis: 92 recovered without complication, 3 succumbed to aorto-oesophageal fistula, 12 survived following delayed surgery for complications and 83 developed oesophageal and/or gastric stenosis which subsequently required endoscopic or surgical treatment.
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542
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Steinman E, Utiyama EM, Bevilacqua RG, Birolini D, de Oliveira MR. [Duodenal injuries]. REVISTA DO HOSPITAL DAS CLINICAS 1987; 42:8-14. [PMID: 3321374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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543
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544
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Rainey JB, Ritchie J. Peritoneal lavage in the diagnosis of traumatic duodenal rupture. Arch Emerg Med 1986; 3:262-3. [PMID: 3801117 PMCID: PMC1285383 DOI: 10.1136/emj.3.4.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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545
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Walker ML. Management of pancreatic trauma: concepts and controversy. J Natl Med Assoc 1986; 78:1177-83. [PMID: 3806692 PMCID: PMC2571413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Four cases of pancreatic trauma are critiqued, and an algorithm to guide management is outlined. The key to operative assessment of pancreatic injury is the presence or absence of major ductal disruption. The surgeon's assessment is usually accurate, but when doubt exists, intraoperative pancreatography is advocated. In patients with significant pancreatic head injury with ductal disruption and associated duodenal injury, pancreaticoduodenectomy is recommended. In spite of reports to the contrary, duodenal diverticulization should be reserved for the patient with a repairable duodenal injury in association with a pancreatic head wound without ductal disruption.
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546
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Honoré P, Jacques M, Moineau D, Meurisse M, Defraigne JO, Bonnet P. [Duodenal injuries]. REVUE MEDICALE DE LIEGE 1986; 41:963-6. [PMID: 3809829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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547
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Abstract
The magnetic resonance (MR) appearance of a case of intramural duodenal hematoma is described and compared with CT findings. Due to the paramagnetic effects of iron, the hematoma was more clearly visualized by MR.
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548
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Romanov PA, Vladimirova ES, Miridzhanian MM. [Anatomic basis for levels of duodenal injury in closed abdominal injuries]. Khirurgiia (Mosk) 1986:63-6. [PMID: 3807209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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549
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Astashkina KV, Borisova GA, Pankov VI, Fedosov MB. [Injury of the duodenum in a child]. VESTNIK KHIRURGII IMENI I. I. GREKOVA 1986; 137:118-9. [PMID: 3787960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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550
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Sarr MG, Fishman EK, Milligan FD, Siegelman SS, Cameron JL. Pancreatitis or duodenal perforation after peri-Vaterian therapeutic endoscopic procedures: diagnosis, differentiation, and management. Surgery 1986; 100:461-6. [PMID: 3738765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The diagnosis, differentiation, and management of severe pancreaticoduodenal complications occurring after therapeutic endoscopic sphincterotomy and related procedures on the ampulla of Vater were reviewed for 254 patients. Five patients had duodenal (peri-Vaterian) perforation and six patients had clinically significant pancreatitis. Most patients were not suspected of having a significant complication the night of the procedure despite abdominal pain. Computer tomography proved to be the most accurate test for establishing the existence of a significant complication. A periduodenal collection of fluid (abscess) without significant pancreatic enlargement was the predominant complication in patients with duodenal perforation. In patients who had pancreatitis after peri-Vaterian procedures, generalized pancreatic enlargement and peripancreatic edema were most prominent. Four of the five patients with duodenal perforation required surgical drainage; all recovered. In contrast, four of the six patients with pancreatitis had medical therapy. One patient with pancreatitis died after multiple pancreatitic debridements were done. A second patient with pancreatitis who underwent exploration eventually recovered. Pancreaticoduodenal complications after therapeutic endoscopic sphincterotomy and related procedures are difficult to diagnose early; they should be suspected early and approached aggressively to limit morbidity and death.
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