Stevens A, Little J M
Department of Surgery, Westmead Hospital, NSW, Australia.
Aust N Z J Surg. 1987 Oct;57(10):709-13. doi: 10.1111/j.1445-2197.1987.tb01248.x.
Fifteen cases of duodenal trauma that presented to Westmead Hospital between 1979 and July 1986 are reviewed. There were 12 blunt injuries, nine caused by motor vehicle accidents. Three patients sustained penetrating injuries, two due to stab wounds. Repair for blunt laceration or incised wound was by primary closure or serosal patch repair, most often with decompressive t-tube duodenostomy. No leak from the duodenal repair occurred in any patient. Two patients died. This was not due to complications of the duodenal injury. Pyloric exclusion, duodenal diverticulization or pancreaticoduodenectomy was not considered necessary in any patient. Morbidity of duodenal haematoma in the form of continuing abdominal pain may be avoided by intra-operative drainage.
回顾了1979年至1986年7月间在韦斯特米德医院就诊的15例十二指肠创伤病例。其中钝性损伤12例，9例由机动车事故所致。3例患者为穿透性损伤，2例因刺伤引起。钝性撕裂伤或切割伤的修复采用一期缝合或浆膜补片修复，多数情况下同时行减压性T管十二指肠造口术。所有患者的十二指肠修复处均未发生渗漏。2例患者死亡，但并非由于十二指肠损伤的并发症。所有患者均未考虑行幽门旷置术、十二指肠憩室化或胰十二指肠切除术。术中引流可避免以持续性腹痛形式出现的十二指肠血肿的发生。
