Zachariah Sanoop Koshy
Department of General, Laparoscopic and Gastrointestinal Surgery, MOSC Medical College Kolenchery, Cochin 682311, India.
Case Rep Surg. 2013;2013:503151. doi: 10.1155/2013/503151. Epub 2013 Mar 23.
Laparoscopic repair of perforated duodenal ulcers is safe and effective in centers with experience and increasingly performed by laparoscopic surgeons. However, the role of laparoscopy for the management of large duodenal perforations (>1 cm) is unclear. To date, no experience has been reported with emergency laparoscopic repair of large perforations for gastroduodenal ulcers. The commonest reason for conversion to open surgery is a perforation size of more than 1 cm. This paper reports a case of a large duodenal perforation due to a nasogastric tube in a 26-year-old male who had undergone a tracheostomy, following a cut-throat injury. This large perforation was successfully diagnosed and repaired laparoscopically. This is probably the first paper in the English literature to report duodenal perforation due to a nasogastric tube in an adult and also the first report of a successful laparoscopic repair of a large duodenal perforation.
在有经验的医疗中心，腹腔镜修复十二指肠穿孔是安全有效的，并且越来越多的由腹腔镜外科医生实施。然而，腹腔镜在处理较大十二指肠穿孔（>1厘米）中的作用尚不清楚。迄今为止，尚无关于急诊腹腔镜修复胃十二指肠溃疡大穿孔的经验报道。转为开放手术最常见的原因是穿孔尺寸超过1厘米。本文报道了1例26岁男性因割喉伤行气管切开术后，鼻胃管导致十二指肠大穿孔的病例。该大穿孔通过腹腔镜成功诊断并修复。这可能是英文文献中第一篇报道成人鼻胃管导致十二指肠穿孔的文章，也是首例成功腹腔镜修复十二指肠大穿孔的报道。
