ABSTRACT
Between 1975 and 1986, 42 patients with duodenal trauma were seen at six major hospitals serving the province of Saskatchewan. Twenty-six patients had blunt trauma and 16 penetrating trauma. The mean age of the patients was 25 years and 38 were male. An assessment of patient management revealed an unacceptable rate of duodenal fistulas (17%) and death (14%). Detailed analysis suggests that duodenal injuries must be diagnosed early with prompt and appropriate surgical correction.
Subject(s)
Duodenum/injuries , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Wounds, Nonpenetrating/complications , Wounds, Nonpenetrating/mortality , Wounds, Nonpenetrating/surgery , Wounds, Penetrating/complications , Wounds, Penetrating/mortality , Wounds, Penetrating/surgeryABSTRACT
Percutaneous endoscopic gastrostomy has been shown by many investigators to be a safe, rapid means of gaining access to the gastrointestinal tract. Over a 3 1/2 year period, 155 percutaneous endoscopic gastrostomies were performed. All of the patients had an inability to nourish themselves orally. The technique described by Ponsky et al was used. Preoperative antibiotics were administered to 108 patients, and most of the procedures were performed under local anesthesia. Many of the procedures were performed in association with tracheostomies. There were 17 complications (11 percent), including 2 deaths (1 percent). Comparison of percutaneous endoscopic gastrostomy to operative gastrostomy revealed percutaneous endoscopic gastrostomy to be superior. We believe that percutaneous endoscopic gastrostomy should be considered the procedure of choice for tube gastrostomy.
