Janson K L, Stockinger F
Am J Surg. 1975 Mar;129(3):304-8. doi: 10.1016/0002-9610(75)90246-9.
Analysis of the fifty-six cases of duodenal hematoma reported since 1966 shows a significant rise in incidence, with uncertainty regarding the most appropriate approaches to therapy. The diagnosis can generally be made by recognizing the "coil spring" sign on upper gastrointestinal series. Thirty-four per cent of the patients reviewed were treated successfully with conservative management. Sixty-two per cent were treated surgically. Fifty-one per cent of the surgical patients were treated by simple evacuation of the hematoma, and 12 per cent of these required reoperation for recurrent obstruction. Forty per cent of the surgical patients were treated by evacuation and gastrojejunostomy, and 21 per cent of these required reoperation for marginal ulceration. A previously unreported case is presented and a new surgical approach utilizing gastroduodenostomy is described, which is believed to offer potentially less risk of subsequent marginal ulceration or recurrent duodenal obstruction.
对1966年以来报告的56例十二指肠血肿病例的分析显示，发病率显著上升，且治疗的最佳方法尚不确定。诊断通常可通过上消化道造影识别“弹簧圈”征来做出。接受复查的患者中，34%经保守治疗成功。62%接受了手术治疗。51%的手术患者通过单纯血肿清除术治疗，其中12%因复发性梗阻需要再次手术。40%的手术患者通过血肿清除术和胃空肠吻合术治疗，其中21%因边缘性溃疡需要再次手术。本文报告了1例此前未报道的病例，并描述了一种采用胃十二指肠吻合术的新手术方法，该方法被认为可能降低随后发生边缘性溃疡或复发性十二指肠梗阻的风险。
