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Laparotomy: The conquering of the abdomen and the historical journey of pancreatic and duodenal injuries. J Trauma Acute Care Surg 2018; 80:1023-31. [PMID: 26958791 DOI: 10.1097/ta.0000000000001010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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2
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Park YC, Jo YG, Kang WS, Park EK, Kim HJ, Kim JC. Isolated Common Hepatic Duct Injury after Blunt Abdominal Trauma. JOURNAL OF TRAUMA AND INJURY 2017. [DOI: 10.20408/jti.2017.30.4.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Yun Chul Park
- Department of Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Young Goun Jo
- Department of Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Wu Seong Kang
- Department of Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Eun Kyu Park
- Department of Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Hee Jun Kim
- Department of Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Jung Chul Kim
- Department of Surgery, Chonnam National University Medical School, Gwangju, Korea
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3
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Western Trauma Association Critical Decisions in Trauma: Diagnosis and management of duodenal injuries. J Trauma Acute Care Surg 2016; 79:1096-101. [PMID: 26680146 DOI: 10.1097/ta.0000000000000870] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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4
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Osei-Boateng K, Ravendhran N, Haluszka O, Darwin PE. Endoscopic treatment of a post-traumatic biliary stricture mimicking a Klatskin tumor. Gastrointest Endosc 2002; 55:274-6. [PMID: 11818940 DOI: 10.1067/mge.2002.120783] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Kwabena Osei-Boateng
- University of Maryland Medical System and Digestive Disease Associates, Baltimore, Maryland 21201, USA
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5
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Lacerations of the Hepatoduodenal Ligament, Pancreas and Duodenum in a Child due to Blunt Impact. J Forensic Sci 1998. [DOI: 10.1520/jfs16120j] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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6
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Sakamoto Y, Tanaka N, Furuya T, Okamoto H, Nagai M, Murakawa T, Nobori M. A simple stenting method for management of hepatic ductal injury secondary to blunt abdominal trauma: two case reports. THE JOURNAL OF TRAUMA 1997; 42:1165-8. [PMID: 9210562 DOI: 10.1097/00005373-199706000-00033] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We report two cases of liver injury with hepatic ductal disruption after blunt abdominal trauma. The first case involves a 23-year-old male. Because the bifurcation of the hepatic duct was longitudinally torn, two stenting catheters were inserted toward the right and left hepatic ducts without suture closure of the tear. The patient is well 10 years after the injury. The second case involves a 22-year-old male who suffered an infarction of the inferior portion of the medial segment of the left hepatic lobe as well as a laceration of the left hepatic duct, a 50% circumferential tear. A stenting catheter was introduced into the left hepatic duct, but the defect was not sutured. The patient is well 1.5 years after the injury. The catheter stenting method without suture repair or defect plasty is a simple and effective way to manage hepatic ductal injury.
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Affiliation(s)
- Y Sakamoto
- Department of Surgery, Asahi General Hospital, Chiba, Japan
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7
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Soffer D, Pamoukian VN, Minski Z, Aladgem D, Kluger Y. Traumatic transection of the intrapancreatic common bile duct due to blunt injury: a case report and literature review. Injury 1996; 27:672-4. [PMID: 9039370 DOI: 10.1016/s0020-1383(96)00102-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- D Soffer
- Department of Surgery, Sourasky Medical Center, Sackler School of Medicine, Tel Aviv, Israel
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8
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Carrillo EH, Richardson JD, Miller FB. Evolution in the management of duodenal injuries. THE JOURNAL OF TRAUMA 1996; 40:1037-45; discussion 1045-6. [PMID: 8656463 DOI: 10.1097/00005373-199606000-00035] [Citation(s) in RCA: 94] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- E H Carrillo
- Department of Surgery, University of Louisville School of Medicine, Kentucky 40292, USA
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9
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Abstract
Non-surgical trauma to the extrahepatic biliary tract is uncommon and encountered only rarely by surgeons outside specialist hepatobiliary centres. Such injury often results in significant morbidity and mortality. This review outlines the incidence, classification, mechanisms of injury, presentation, diagnostic techniques and management options. Depending on the type of biliary injury identified, an optimal method of repair is suggested. Recommendations are made for surgeons who encounter this type of injury and do not have the appropriate expertise for definitive management.
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Affiliation(s)
- R W Parks
- Department of Surgery, Queen's University of Belfast, UK
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10
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Yokota J, Sugimoto T. Clinical significance of periportal tracking on computed tomographic scan in patients with blunt liver trauma. Am J Surg 1994; 168:247-50. [PMID: 8080062 DOI: 10.1016/s0002-9610(05)80196-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
This study was undertaken to evaluate the clinical significance of periportal tracking on computed tomography (CT) in patients with blunt liver trauma. The clinical records and CT findings of 88 patients were reviewed. Angiographic study revealed potential injury to portal triads in patients with periportal tracking on CT. Extrahepatic injuries beneath the liver were associated in 22 of 28 patients with periportal tracking and in 2 of 17 without periportal tracking (P < 0.01, chi-square = 16.38). Hepatic complications such as bile leak, biloma, hemobilia, and infected hematoma were evaluated separately in 43 patients treated conservatively and 45 patients treated surgically. The incidence of complications in patients with periportal tracking was significantly higher in both groups (nonoperative; P < 0.01, chi-square = 8.46 and operative; P < 0.01, chi-square = 8.48). We conclude that periportal tracking on CT implies injury to the subhepatic region and intrahepatic portal triads and that it requires careful examination for extrahepatic injuries in the initial management and late hepatic complications in the follow-up management.
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Affiliation(s)
- J Yokota
- Department of Traumatology, Osaka University Medical School, Japan
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12
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MESH Headings
- Duodenum/injuries
- Duodenum/surgery
- Hematoma/etiology
- History, 19th Century
- History, 20th Century
- Humans
- Rupture
- Survival Rate
- Wounds, Nonpenetrating/complications
- Wounds, Nonpenetrating/diagnosis
- Wounds, Nonpenetrating/history
- Wounds, Nonpenetrating/mortality
- Wounds, Nonpenetrating/surgery
- Wounds, Penetrating/diagnosis
- Wounds, Penetrating/history
- Wounds, Penetrating/mortality
- Wounds, Penetrating/surgery
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Affiliation(s)
- J A Asensio
- Division of Trauma Surgery and Surgical Critical Care, Hahnemann University School of Medicine, Philadelphia, Pennsylvania
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13
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Ito T, Yamamoto M, Machida H, Hashiguchi Y, Yatsuda N, Yasuda M. Complete avulsion of the papilla of Vater and gastroduodenal artery due to blunt abdominal trauma: report of a case. Surg Today 1993; 23:172-5. [PMID: 8096774 DOI: 10.1007/bf00311238] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A case of traumatic avulsion of the papilla of Vater and gastroduodenal artery successfully treated by pancreaticoduodenectomy is presented herein. The mechanism of this rare injury appeared to be a shearing force applied to the common bile duct and gastroduodenal artery. Thus, when the liver is driven cephalad by compression of the abdomen and by the deceleration force, the common bile duct and gastroduodenal artery are avulsed from the fixed duodenum and pancreas. The mechanism of this rare injury is postulated on the basis of operative and histological findings. Our case is thought to be the first of traumatic avulsion of the papilla of Vater and gastroduodenal artery to be reported in Japan.
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Affiliation(s)
- T Ito
- School of Allied Medical Sciences, Nagasaki University, Japan
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Cooke HS. Avulsion of the ampulla of Vater following blunt trauma. THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY 1990; 60:393-6. [PMID: 2334362 DOI: 10.1111/j.1445-2197.1990.tb07390.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Avulsion of the ampulla of Vater associated with a duodenal laceration occurred in a 14 year old girl involved in a motor vehicle accident. The duodenal laceration was repaired, and the common bile duct reimplanted into the second part of the duodenum, 1.5 cm proximal to the site of rupture. This method of reconstruction gave a good result in this rare injury, of which only four similar cases were found reported in the literature.
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Affiliation(s)
- H S Cooke
- Department of Surgery, Christchurch Hospital, New Zealand
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15
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Abstract
The majority of patients who sustain penetrating blunt trauma to the pancreas can be managed with sump drainage, including those with gunshot wounds to the head of the pancreas. Pancreatico-duodenectomy may be indicated in 2 to 3 percent of cases of pancreatic injury. Patients who require resection of 80 percent or more of the pancreas and do not have splenic injury should be considered for a Roux-Y anastomosis to the distal pancreas after ductal injury has been proved. Severe injuries to the body of the pancreas are best managed by distal pancreatectomy. The mortality rate due to pancreatic injury has been less than 3 percent and rarely is the cause of death. To support this conclusion, few normotensive patients die, and no patient with an isolated pancreatic injury in our series died. The severity of injury often dictates the appropriate treatment. A conservative approach is indicated for most pancreatic injuries, resulting in shorter operating time and less blood loss in the unstable patient with multiple injuries. Most important is identification of ductal injury at the initial operation and institution of surgical drainage.
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Feliciano DV, Bitondo CG, Burch JM, Mattox KL, Beall AC, Jordan GL. Management of traumatic injuries to the extrahepatic biliary ducts. Am J Surg 1985; 150:705-9. [PMID: 4073363 DOI: 10.1016/0002-9610(85)90413-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
From 1978 through 1984, 13 patients with traumatic injuries to the extrahepatic biliary ducts were treated. Twelve of the 13 patients had penetrating wounds, and associated intraabdominal injuries were uniformly present. Multiple types of operative repair were successfully utilized, with the choice dictated by the patient's condition and the location and extent of the ductal injury. In stable patients with partial tears or small through-and-through injuries, lateral repair with or without T-tube stenting was used successfully. With ductal transections, an end-to-end anastomosis or a bilioenteric anastomosis was used. The Whipple procedure was reserved for complex periampullary injuries. Morbidity was related to the complexity of the ductal repair, whereas mortality (4 of 13 patients, 31 percent) was related to associated injuries.
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Kawarada Y, Tani K, Yoshimine S, Mizumoto R. Blunt injury of duodenum with avulsion of papilla of Vater--report of a case. THE JAPANESE JOURNAL OF SURGERY 1984; 14:499-504. [PMID: 6530845 DOI: 10.1007/bf02469793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
In a 52-year-old man, there was a complete separation of the duodenum with avulsion of the papilla of Vater from the head of the pancreas due to blunt abdominal trauma. He was successfully treated by an anastomosis of the ampulla to the jejunum of a Roux-en Y limb, after removal of the entire duodenum and partial gastrectomy, followed by gastrojejunostomy of the Billroth II-type, instead of pancreaticoduodenectomy. The patient is well at 15 months after this surgery.
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Kitahama A, Elliott LF, Overby JL, Webb WR. The extrahepatic biliary tract injury: perspective in diagnosis and treatment. Ann Surg 1982; 196:536-40. [PMID: 6812512 PMCID: PMC1352784 DOI: 10.1097/00000658-198211000-00005] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Nonsurgical trauma to the extrahepatic biliary tract is being reported with increasing frequency. There has been no recent review of the management of these injuries. Forty patients over the past twelve years at Charity Hospital, New Orleans, were studied. The 10% mortality rate was due to associated injuries. Tangential injuries were best managed by suture closure and T-tube drainage. Biliary-enteric anastomoses were most successful in the treatment of complete transections. Delayed diagnosis is not uncommon, and new methods of diagnosis are discussed. Injuries of this nature are responsible for high morbidity rates due to fistula or stricture formation. Successful management of these injuries is vital, even in those patients with more severe associated injuries.
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Burt TB, Nelson JA. Extrahepatic biliary duct trauma--a spectrum of injuries. West J Med 1981; 134:283-9. [PMID: 7245733 PMCID: PMC1272680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Blunt traumatic injury of the extrahepatic bile ducts (EBD) is uncommon. Familiarity with the wide spectrum of possible EBD injuries is essential, however, because of the increasing number of nonpenetrating abdominal injuries seen in modern society. These injuries include contusion with edema, hematoma and varying degrees of laceration. Edema and hematoma can result in transient bile duct obstruction that clears spontaneously or cicatrizing inflammatory reaction resulting in stricture and obstruction. Common bile duct stricture following blunt trauma is extremely rare, but is an unfortunate late complication requiring biliary decompression to relieve progressive jaundice. Laceration (partial or complete) can occur at any location in the EBD and can be life-threatening if the diagnosis is overlooked. Hemobilia is an unusual complication of laceration of the EBD. Failure to recognize the clinical manifestations of these uncommon injuries results in delayed and often incorrect diagnoses. Percutaneous transhepatic cholangiography is a safe and accurate procedure that is an important step in the workup of jaundice following blunt trauma.
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Busuttil RW, Kitahama A, Cerise E, McFadden M, Lo R, Longmire WP. Management of blunt and penetrating injuries to the porta hepatis. Ann Surg 1980; 191:641-8. [PMID: 7369824 PMCID: PMC1344756 DOI: 10.1097/00000658-198005000-00017] [Citation(s) in RCA: 56] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Injuries to the porta hepatis pose difficult problems in management, and transection of the bile ducts, portal vein and hepatic artery is among the most challenging. Twenty-one patients with severe injuries to the porta hepatis were treated over a ten-year period. Ages ranged from 13 to 56 years, and follow-up was up to nine years. Among the 14 patients with bile duct injury, eight were found to have complete transection, and five suffered a tangential laceration or incomplete disruption with a portion of a duct wall remaining intact. Five of the eight patients who had complete transection underwent primary end-to-end repair with T-tube splinting, while three were treated with primary Roux-en-Y choledocojejunostomy. All patients with incomplete disruption underwent primary repair with or without T-tube splinting. Of the five patients with complete disruption who were treated with primary end-to-end anastomosis of the bile duct in conjunction with T-tube splinting, all required secondary biliary tract reconstruction of some type. No patient with complete transection that was treated with primary Roux-en-Y biliary enteric anastomosis required reoperation. Partial transections were successfully treated with primary repair. Portal vein injury was encountered in ten patients. Injury was successfully managed by primary closure, interposition of a vein, or splenicmesenteric vein bypass. Associated injuries to liver, pancreas, kidney and duodenum were common. In four patients there was injury to the main or left or right hepatic artery which was managed successfully by repair or ligation, with or without hepatic lobectomy. By adhering to the principles of management to be outlined, many patients with injury to the porta hepatis will survive, and the long term outcome can be gratifying.
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Abstract
Five cases of traumatic intramural haematoma of the duodenum occurring in children are presented. Four of the cases were treated conservatively with nasogastric aspiration and intravenous fluids and it is suggested that this should be the treatment of choice in the majority of cases. Two of the cases were diagnosed initially as having appendicitis and during the exploratory procedure in one of these cases the haematoma was evacuated.
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Stevenson JH. Severe thoracic intra-abdominal and vertebral injury occurring in combination in a patient wearing a seat belt. Injury 1979; 10:321-3. [PMID: 478631 DOI: 10.1016/0020-1383(79)90054-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Parkinson SW, Wisniewski ZS. Avulsion of the ampulla of Vater: an isolated injury following blunt abdominal trauma. THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY 1978; 48:562-4. [PMID: 285704 DOI: 10.1111/j.1445-2197.1978.tb00046.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
A case of avulsion of the ampulla of Vater from the duodenum due to blunt trauma is presented. In patients in whom leakage is confined to the extra peritoneal tissues, the condition can be insidious, making diagnosis difficult.
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Shorthouse AJ, Singh MP, Treasure T, Franklin RH. Isolated complete transection of the common bile duct by blunt abdominal trauma. Br J Surg 1978; 65:543-5. [PMID: 678767 DOI: 10.1002/bjs.1800650805] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Isolated complete transection of the common bile duct due to blunt trauma is rare. Its occurrence and successful treatment in an 8-year-old boy are described. Inital minor peritonism resolved quickly, followed by a deceptive asymptomatic period and insidious development of jaundice, anorexia, vomiting, pain, acholic stools and progressive abdominal distension due to sterile biliary ascites. A preliminary cholecystostomy was followed by construction of a Roux-en-Y cholecystojejunostomy.
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Abstract
Since 1950, 300 patients sustaining pancreatic injuries have been managed. Three-fourths of the injuries were due to penetrating trauma with a 20% mortality and one-fourth due to blunt trauma resulting in an 18% mortality. The pancreatic injury was responsible for death in only 3% of patients. Early onset of shock resulted in 38% mortality whereas only 4% of normotensive patients died. No patient died of an isolated pancreatic injury. Sepsis was the second most common cause of death following hemorrhage. Preoperative serum amylase was elevated more frequently following blunt trauma than penetrating trauma, but did not correlate with injury. There has been a tendency toward more frequent use of distal pancreatectomy for simple penetrating injuries without obvious ductal violation which increases operative time, blood loss and possible intra-abdominal abscess since resection usually requires splenectomy. Patients considered for an 80% distal resection are better managed with a Roux-en-Y limb to the distal pancreas since three patients developed diabetes following an 80% or greater resection. A conservative approach consisting of Penrose and sump drainage is adequate for most injuries.
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Strachan JCM. Retroperitoneal rupture of the duodenum due to blunt trauma. Postgrad Med J 1974. [DOI: 10.1136/pgmj.50.581.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Buxton B. Rupture of the Duodenum Produced by a Safety Belt. THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY 1972; 38:315-320. [PMID: 29265287 DOI: 10.1111/j.1445-2197.1972.tb05645.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The case report of a patient who sustained a traumatic rupture of the first part of the duodenum as a result of the restraint produced by a seat belt is presented. The literature on closed rupture of the duodenum is reviewed, and the possible mechanism of injury is discussed. SUMMARY A case of closed rupture of the first part of the duodenum as the result of injury due to the restraint produced by a safety belt is presented. The literature on closed rupture of the duodenum and seat belt injuries is briefly reviewed. The possible mechanisms of injury to the duodenum are discussed. The considered evidence in this case suggests that the body was thrown on to the loose safety belt, sustaining a blow to the right hypochondrium during a period in which the duodenum was distended, with the consequent production of explosive rupture of its first part.
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Affiliation(s)
- Brian Buxton
- University of Melbourne Department of Surgery, Royal Melbourne Hospital
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Allen RE, Eastman BA, Halter BL, Conolly WB. Retroperitoneal hemorrhage secondary to blunt trauma. Am J Surg 1969; 118:558-61. [PMID: 5821691 DOI: 10.1016/0002-9610(69)90183-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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