Clinical Hospital Center Rijeka, Department of Abdominal Surgery, Rijeka, Croatia.
Wien Klin Wochenschr. 2010 Jan;122(1-2):54-6. doi: 10.1007/s00508-009-1300-x.
We report a case of a 20-year-old male with isolated complete duodenal transection at two duodenal segments after blunt abdominal trauma. On admission, the patient underwent physical examination, laboratory analysis, abdominal ultrasound and plain abdominal x-ray. Physical examination revealed diffuse and rebound tenderness and extreme rigidity of the abdomen, guarding and decreased bowel sounds. Standard surgical techniques were used (median laparotomy, primary anastomosis, nasojejunal three-luminal tube for feeding and gastric decompression). At exploration, we found complete transection of the duodenum just below the pylorus and between the second and third part of the duodenum. We performed primary anastomosis of both transections with interrupted sutures in two layers. Prior to discharge magnetic resonance imaging (MRI) was performed. Early diagnosis of duodenal rupture is important. When dealing with trauma patients with pain greater than local findings, the mechanism of injury should always be taken into account.
我们报告了一例 20 岁男性患者，在钝性腹部创伤后两个十二指肠段发生孤立性完全性十二指肠横断。入院时，患者进行了体格检查、实验室分析、腹部超声和腹部平片检查。体格检查显示腹部弥漫性和反弹压痛，腹壁极度强直，有压痛和肠鸣音减弱。采用标准手术技术（正中剖腹术、一期吻合术、空肠三腔管用于喂养和胃减压）。探查时，我们发现幽门以下和十二指肠第二、三段之间的十二指肠完全横断。我们采用间断缝合双层法对两个横断进行一期吻合。出院前进行了磁共振成像（MRI）检查。早期诊断十二指肠破裂很重要。在处理疼痛大于局部表现的创伤患者时，应始终考虑损伤机制。
