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十二指肠憩室穿孔并腹膜炎患者的胰十二指肠切除术:病例报告

Pancreatoduodenectomy in patient with perforated duodenal diverticulum and peritonitis: Case report.

作者信息

Philip Justus, Cocieru Andrei

机构信息

Department of Surgery, Summa Akron City Hospital, Akron, Ohio, United Staes.

Department of Surgery, Summa Akron City Hospital, Akron, Ohio, United Staes; Northeastern Ohio Medical University, Roostown, Ohio, United Staes.

出版信息

Int J Surg Case Rep. 2019;58:48-49. doi: 10.1016/j.ijscr.2019.04.011. Epub 2019 Apr 10.

Abstract

INTRODUCTION

Duodenal diverticula are quite prevalent in general population, seen on up to 5% of radiology studies and up to 22% of autopsy examinations.

PRESENTATION OF THE CASE

70 years old female was admitted to the hospital with epigastric pain, fevers and elevated white cell count. Abdominal CT scan demonstrated evidence of perforated duodenal diverticulitis which failed to improve with IV antibiotics. Emergent pancreatoduodenectomy was performed with full recovery and uncomplicated hospital stay.

DISCUSSIONS

Conservative therapy with antibiotics and bowel rest is successful in majority cases of perforation. Failure of conservative therapy demands surgical management. Variety of surgical approaches ranging from simple diverticulectomy to segmental resection, duodenal exclusion/bypass to pancreatoduodenectomy are available.

CONCLUSION

Pancreatoduodenectomy is an option when complicated duodenal diverticulum is not resolved with conservative or interventional therapy.Pancreatoduodenectomy is an option when complicated duodenal diverticulum is not resolved with conservative or interventional therapy. This report has been written in concordance with the SCARE criteria Agha et al. [1].

摘要

引言

十二指肠憩室在普通人群中相当常见,在高达5%的放射学检查和高达22%的尸检中可见。

病例介绍

一名70岁女性因上腹部疼痛、发热和白细胞计数升高入院。腹部CT扫描显示十二指肠憩室炎穿孔的证据,静脉使用抗生素治疗无效。急诊行胰十二指肠切除术,患者完全康复,住院过程顺利。

讨论

大多数穿孔病例采用抗生素和肠道休息的保守治疗是成功的。保守治疗失败需要手术处理。有多种手术方法可供选择,从简单的憩室切除术到节段性切除术、十二指肠旷置/旁路术再到胰十二指肠切除术。

结论

当复杂的十二指肠憩室经保守或介入治疗无法解决时,胰十二指肠切除术是一种选择。本报告是根据Agha等人[1]的SCARE标准撰写的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0920/6476798/89d854ed9f47/gr1.jpg

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