IJIMS.2016.117

Type of Article: Case Report

Volume 3; Issue 5: May 2016

Page No.: 280-284

DOI: 10.16965/ijims.2016.117

Case Report on Two Large Duodenal Perforations and Their Management in Emergency Conditions

Devendra K. Prajapati *1, Kapil Rampal 1,  Mukesh Soni 2, Jyoti M Prajapati 3.

*1 Senior Resident Department of Surgery, Deendayal Upadhyay Hospital, New Delhi, India.

2 DNB (sch)   Department of Surgery, Deendayal Upadhyay Hospital, New Delhi, India.

3 Scholar in Computer Application, Deendayal Upadhyay Hospital, New Delhi, India.

CORRESPONDING AUTHOR ADDRESS: Dr. Devendra   K   Prajapati, WZ 423 A Nanakpura Harinagar, New Delhi, 110064, India. E-Mail: dr.dev1982@gmail.com

ABSTRACT

Duodenal trauma and its management has always been a hard task and presents as a situational dilemma in surgical emergencies. Very limited work guidelines and standards are available for the management of these complex injuries. Triple tube technique as pure procedure or with its situational modifications is seen as an ideal repair for duodenal perforations. Gastrojejunostomy seemingly is a better option to gastrostomy when large perforations are being repaired for which lumen narrowing is expected.

KEY WORDS: Duodenum, Trauma, Surgical Emergencies, Triple Tube Technique.

REFERENCES

  1. Ivatury RR. Duodenal injuries: small but lethal lesions. Cirujano General 2003; 25(1):59-65.
  2. Acosta J. Management of Specific Injuries, Injuries to the Duodenum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery. 18th ed. Philadelphia: Saunders-Elsevier; 2008. p. 505-6.
  3. Carrillo EH, Richardson JD, Miller FB. Evolution in the management of duodenal injuries. J Trauma 1996;40:1037-6
  4. Moore E E, Cogbill T H, Malangoni M D, Jurkovich G J, Champion H R, Gennarelli T A, McAninch J W, Pachter H L, Shackford S R, Trafton P G. Organ injury scaling, II: Pancreas, duodenum, small bowel, colon and rectum. J Trauma. (1990);30(11):1427–1429.
  5. Lucas CE, Ledgerwood AM. Factors influencing outcome after blunt duodenal injury. J Trauma 1975;15:839-46
  6. Olsen WR. The serum amylase in blunt abdominal trauma. J Trauma. 1973;13:201–4.
  7. Huerta S, Bui T, Porral D, Lush S, Cinat M. Predictors of morbidity and mortality in patients with traumatic duodenal injuries. Am Surg 2005;71(9):763-7.
  8. Jurkovich GJ, Bulger EM. Duodenum and pancreas. In: Moore EE, Feliciano DV, Mattox KL, Eds. Trauma. 5th Ed., New York, McGraw Hill, 2003, p:709-34.
  9. Crippa S, Falconi M, Bettini R, et al. Isola-ted Blunt Duodenal Trauma: Delayed Diagnosis and Favorable Outcome with “Quadruple Tube” De-compression. JOP 2007;8(5):617-20.
  10. Brofman N, Atri M, Hanson JM, Grinblat L, Chughtai T, Brenneman F. Evaluation of bowel and mesenteric blunt trauma with multidetector CT. Radiographics 2006; 26(4):1119-31.
  11. Miller LA, Shanmuganathan K. Multidetec-tor CT evaluation of abdominal trauma. Radiol Clin North Am 2005;43(6):1079-95.
  12. Scaglione M, de Lutio di Castelguidone E, Scialpi M, Merola S, Diettrich AI, Lombardo P. Blunt trauma to the gastrointestinal tract and mesentery: is there a role for helical CT in the decision-making process? Eur J Radiol 2004;50(1):67-73.
  13. Brooks AJ, Boffard KD. Current techno-logy: laparoscopic surgey in Trauma. Trauma 1999; 1(1):53-60.
  14. Stone HH, Fabian TC. Management of duodenal wounds. J Trauma. 1979;19:334–9.
  15. Garcı´a-Nun˜ ez LM, Nun˜ ez-Cantu´ O, Cabello-Pasini R, Delgado-Aramburo JL, Soto-Ortega LE, Rivera-Cruz JM, et al. Trauma duodenal complejo. Co´mo elegir la terapeu´ tica. Rev Sanid Milit Mex. 2008;62:109–17.
  16. Kobbold EE, Thal AP. A simple method for the management of experimental wounds to the duodenum. Surg Gynecol Obstet. 1963;116:340–4.
  17. De Shazo CV, Snyder WH, Daugherty CG, Crenshaw CA. Mucosal pedicle graft of the jejunum for large gastrointestinal defects. Am J Surg. 1972;124:671–2.

 

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