Subject(s)
Brachiocephalic Trunk/injuries , Subclavian Artery/injuries , Adult , Aged , Brachiocephalic Trunk/diagnostic imaging , Brachiocephalic Trunk/surgery , Brachiocephalic Veins/diagnostic imaging , Brachiocephalic Veins/injuries , Brachiocephalic Veins/surgery , Female , Humans , Male , Methods , Middle Aged , Radiography , Subclavian Artery/diagnostic imaging , Subclavian Artery/surgerySubject(s)
Abdominal Injuries/surgery , Laparotomy , Wounds, Gunshot/surgery , Adolescent , Adult , Aged , Evaluation Studies as Topic , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
Six cases of pancreatoduodenectomy performed for combined injuries of the pancreas, duodenum, and/or distal common duct are reported. Pancreatoduodenectomy is indicated when there is extensive destruction of the pancreatic head in conjunction with major injuries of the duodenum, distal common duct, and/or retropancreatic portal vein, necessitating complete division of the pancreatic head. Reconstruction is best achieved by end-to-end pancreatiocieiunostomy, end-to-side choledochojejunostomy, antrectomy, and vagotomy.
Subject(s)
Duodenum/surgery , Pancreas/injuries , Pancreatectomy , Wounds, Penetrating/surgery , Adolescent , Adult , Duodenum/injuries , Humans , Male , Pancreatic Ducts/injuries , Postoperative Complications , Wounds, Gunshot/surgeryABSTRACT
Two hundred forty-six patients admitted to the Trauma Unit of Cook County Hospital with penetrating neck wounds have been reviewed. A policy of mandatory neck exploration combined with a systematic approach to resuscitation and a diagnostic evaluation including neck and chest X-rays, endoscopy, and arteriography has been employed. The study has revealed a high incidence of negative neck explorations (63%) but minimal morbidity (less than 1%), no mortality, and a brief duration of hospitalization in the negative exploration group. Patients with positive explorations had an 8% morbidity and a 9% mortality rate. In addition, 13 of the patients with positive explorations had clinically negative wounds which might have been overlooked if selective management had been utilized in this series. We conclude that a policy of mandatory neck exploration is justified and advisable for patients sustaining penetrating neck injuries.
Subject(s)
Neck Injuries , Wounds, Penetrating/surgery , Adolescent , Adult , Arteriovenous Fistula/complications , Brachiocephalic Trunk/diagnostic imaging , Female , Humans , Male , Middle Aged , Neck/surgery , Radiography , Wounds and Injuries/diagnosis , Wounds, Gunshot/diagnostic imaging , Wounds, Gunshot/surgery , Wounds, Penetrating/mortality , Wounds, Stab/surgerySubject(s)
Alcoholism/complications , Pancreatitis , Abscess/etiology , Acute Disease , Acute Kidney Injury/etiology , Amylases/blood , Ascites/etiology , Catalase/blood , Clinical Enzyme Tests , Humans , Hyperlipidemias/etiology , Lipase/blood , Nutritional Physiological Phenomena , Pancreatic Cyst/etiology , Pancreatitis/complications , Pancreatitis/diagnosis , Pancreatitis/etiology , Pancreatitis/therapy , Pleural Effusion/etiology , Respiratory Insufficiency/etiologySubject(s)
Pancreatitis/classification , Acute Disease , Alcoholism/complications , Humans , PrognosisSubject(s)
Cyclic AMP/blood , Pancreatitis/blood , Acute Disease , Alcoholism/complications , Cyclic AMP/urine , Humans , Pancreatitis/urine , PrognosisABSTRACT
Four cases of extensive corrosive gastric injury requiring surgical treatment are presented. Appropriate management of this life-threatening entity requires an awareness of its subtle presentation plus a well planned surgical approach.
