Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan.
J Pediatr Surg. 2012 May;47(5):E11-4. doi: 10.1016/j.jpedsurg.2011.12.019.
Duodenal perforation secondary to blunt abdominal trauma in children is rare and usually associated with delays in diagnosis and surgical intervention. The authors encountered such a case in a 12-year-old boy owing to his falling over the handlebar of a bicycle. Imaging examination showed that there was a perforation over the fourth portion of the duodenum without concomitant injuries. Using a 5-port transperitoneal laparoscopic technique, primary closure of the perforation was successfully performed at 6 hours after the impact. Laparoscopic approach appears to be safe and feasible in hemodynamically stable children with solitary traumatic duodenal perforation if the operation can be performed early in the course of the incident.
儿童因钝性腹部外伤导致的十二指肠穿孔较为罕见,且通常与诊断和手术干预的延迟相关。由于患儿从自行车把手处摔倒,作者遇到了这样一个病例。影像学检查显示十二指肠第四段存在穿孔,但无其他伴随损伤。使用五孔经腹腔腹腔镜技术,在受伤后 6 小时成功对穿孔进行了一期缝合。如果在事件发生早期进行手术,对于血流动力学稳定、仅有孤立性外伤性十二指肠穿孔的儿童,腹腔镜方法似乎是安全且可行的。