Ivatury Rao R, Malhotra Ajai K, Aboutanos Michel B, Duane Therese M
, 1200 East Broad Street, W15E Rihmond, VA, 23298, USA.
Division of Trauma, Critical Care and Emergency Surgery, Virginia Commonwealth University Medical Center, Richmond, VA, USA.
Eur J Trauma Emerg Surg. 2007 Jun;33(3):231-7. doi: 10.1007/s00068-007-7078-5. Epub 2007 Jun 6.
Duodenal injuries are uncommon injuries but are associated with significant morbidity and mortality from a delayed diagnosis in the case of blunt trauma and associated major vascular injuries in penetrating trauma. A simplistic approach with primary repair or resection and anastomosis is ideal for the vast majority. Complex procedures such as pyloric exclusion with or without gastrojejunostomy may be indicated for delayed treatment or severe, high-grade combined pancreato-duodenal injuries. A high index of suspicion and a judicious treatment plan based on a careful consideration of all the available options are crucial for optimal outcome.
十二指肠损伤并不常见,但钝性创伤导致诊断延迟以及穿透性创伤伴有重大血管损伤时,会出现显著的发病率和死亡率。对于绝大多数病例,采用一期修复或切除吻合的简单方法是理想的。对于延迟治疗或严重的、高级别的胰十二指肠联合损伤,可能需要进行诸如带或不带胃空肠吻合术的幽门旷置等复杂手术。高度的怀疑指数以及基于对所有可用选项的仔细考虑而制定的明智治疗计划对于获得最佳结果至关重要。