Diagnosis and treatment of closed injury of the duodenum / 中国普通外科杂志

Objective To investigate the early diagnosis, indications of operation, choice of operative procedure and effect of operation of closed injury of the duodenum . Methods The clinical data of 38 cases of closed injury of the duodenum treated in recent 11 years were retrospectively analysed . Results Thirty cases(78.9%) were diagnosed preoperatively, and 8 were misdiagnosed(21.1%). All of the 38 patients underwent surgical treatment. 36 cases(94.7%) were cured ,and 2 died(5.3%). Complications occurred in 9(23.7%) .Duodenal fistula was the main complication .Conclusions One must be alert to the possibility of injury of the duodenum in patients with closed upper abdominal injury. Early diagnosis, early operation and rational choice of surgical procedure are very important for the treatment of duodenal trauma.

Decision of surgical treatment for retroperitoneal hematoma / 中国普通外科杂志

0.05),but between the I,II area and III area(28.81%) were significant difference (?2=34.73 P

Treatment of severe duodenal trauma / 中国普通外科杂志

Objective To study the operative method for severe duodenal trauma.Methods The clinical data of 38 cases of severe duodenal trauma complicated with pancreatic injury who underwent different operations between 1992—2006 year were reviewed.Results In 8 cases duodenal diverticulization was performed,of which 5 cases were cured,2 cases developed intestinal fistula,and one died.Of 9 cases who underwent panceaticoduodenectomy(PD),3 were cured but 6 had pancreatic leakage,and 3 of them died.Of 16 cases who had primary repair of ruptured duodenum with simple suture or patch suture,13 cases cured,2 cases developed intestinal fistula and one patient died.Five patients underwent duodenal repair and excision of head of pancreas plus pancreaticojejunostomy(PD with preserved duodenum),4 cases recovered and 1 had pancreatic leakage,but 3 with wrap-type pancreaticojejunostomy had no complications.Conclusions The repair of ruptured duodenum with simple suture plus duodenostomy and jejunostomy is preferential option for majority of cases of duodenal trauma.This procedure plus removal of head of pancreas and pancreaticojejunostomy(PD with preserved duodenum) can be used for severe pancreatic injury with excellent result,but duodenal diverticulization or panceaticoduodennectomy must not be undertaken lightly.