Mokka R E, Kairaluoma M I, Huttunen R, Larmi T K
Ann Chir Gynaecol. 1976;65(1):33-7.
Five patients with blunt retroperitoneal injury of the duodenum are presented. In three of them the trauma was caused by a traffic accident, the most common mechanism of such injuries. One patient died. The high index of suspicion is still the best indication for laparotomy in retroperitoneal injuries of the duodenum, because no typical finding or reliably diagnostic test could be demonstrated even in the present study. The proper treatment in less severe injuries of the retroperitoneal duodenum is evacuation of the hematoma or simple suture of the rupture with drainage and naso-gastric suction. Internal drainage as an afferent jejunostomy is sometimes necessary in the treatment of more severe injuries. Pancreatoduodenectomy is to be reserved for only the very severe duodenal injuries, where the head of the pancreas is badly crushed.
本文报告了5例十二指肠钝性腹膜后损伤患者。其中3例损伤由交通事故所致，这是此类损伤最常见的机制。1例患者死亡。对于十二指肠腹膜后损伤，高度怀疑仍是剖腹探查的最佳指征，因为即使在本研究中也未发现典型表现或可靠的诊断性检查。对于腹膜后十二指肠较轻损伤的恰当治疗是清除血肿或对破裂处进行简单缝合，并置管引流及鼻胃管吸引。对于较严重损伤的治疗，有时需要行空肠输入袢吻合术作为内引流。胰十二指肠切除术仅适用于胰腺头部严重挤压伤等极其严重的十二指肠损伤。
