Poyrazoglu Yavuz, Duman Kazim, Harlak Ali
Department of General Surgery, Mevki Military Hospital, Ankara, Turkey.
Department of General Surgery, Elazig Military Hospital, Elazig, Turkey.
Indian J Surg. 2016 Jun;78(3):209-13. doi: 10.1007/s12262-016-1479-9. Epub 2016 Apr 5.
Complex anatomical relation of the duodenum, pancreas, biliary tract, and major vessels plays to obscure pancreaticoduodenal injuries. Causes of pancreaticoduodenal injuries are blunt trauma (traffic accidents, sport injuries) in 25 % of cases and penetrating abdominal injuries (stab wounds and firearm injuries) in 75 % of cases. Duodenal injuries are reported to occur in 0.5 to 5 % of all abdominal trauma cases and are observed in 11 % of abdominal firearm wounds, 1.6 % of abdominal stab wounds, and 6 % of blunt trauma. Retroperitoneal and deep abdominal localization of duodenum as an organ contribute to the difficulty in diagnosis and treatment. There are three important major points regarding treatment of duodenal injuries: (1) operation timing and decision, (2) Intraoperative detection, and (3) post-operative care. Therefore, it is difficult to diagnose and treat duodenal trauma. We would like to present a 21-year-old male patient with pancreaticoduodenal injury who presented to our emergency service after firearm injury to his abdomen and discuss his treatment with a short review of related literature.
十二指肠、胰腺、胆道和主要血管之间复杂的解剖关系使得胰十二指肠损伤难以被发现。胰十二指肠损伤的原因在25%的病例中是钝性创伤（交通事故、运动损伤），在75%的病例中是腹部穿透伤（刺伤和火器伤）。据报道，十二指肠损伤在所有腹部创伤病例中的发生率为0.5%至5%，在腹部火器伤病例中的发生率为11%，在腹部刺伤病例中的发生率为1.6%，在钝性创伤病例中的发生率为6%。十二指肠作为一个位于腹膜后和腹部深处的器官，增加了诊断和治疗的难度。关于十二指肠损伤的治疗有三个重要要点：（1）手术时机和决策，（2）术中检测，（3）术后护理。因此，十二指肠创伤的诊断和治疗都很困难。我们将介绍一名21岁的男性胰十二指肠损伤患者，他在腹部遭受火器伤后被送到我们的急诊室，并结合相关文献的简短回顾来讨论他的治疗情况。
