Surgical management of complex duodenal trauma using laterolateral duodenum enteroanastomosis: A case report.

Autor:	Galdino DT; Hospital Municipal São José, Trauma Surgery, 488 Dr Plácido Gomes Street, Joinville, Brazil., Welter CDS; Hospital Municipal São José, General surgery residency, 488 Dr Plácido Gomes Street, Joinville, Brazil., Frainer DA; Universidade da Região de Joinville, Medical School, 270 Rio do Sul Street, Joinville, Brazil. Electronic address: djuliafrainer@gmail.com., Theis C; Hospital Municipal São José, General surgery residency, 488 Dr Plácido Gomes Street, Joinville, Brazil., Haas IGF; Universidade da Região de Joinville, Medical School, 270 Rio do Sul Street, Joinville, Brazil., Fiamoncini H; Universidade da Região de Joinville, Medical School, 270 Rio do Sul Street, Joinville, Brazil.
Jazyk:	angličtina
Zdroj:	International journal of surgery case reports [Int J Surg Case Rep] 2021 Dec; Vol. 89, pp. 106648. Date of Electronic Publication: 2021 Dec 02.
DOI:	10.1016/j.ijscr.2021.106648
Abstrakt:	Introduction and Importance: Duodenal trauma is rare, however, it has high morbidity and mortality rates. Surgical treatment modalities are employed depending on severity, ranging from simple sutures to complex pancreaticoduodenectomy cases. Case Presentation: A male patient had a circular saw accident, leading to evisceration in an extensive wound from the thoracoabdominal transition to the inguinal region, with 75% laceration of the second duodenal portion circumference, laceration in hepatic segments, section from right mesocolon to transverse colon, and multiple perforations in small bowel loops between 70 and 90 cm from the angle of Treitz. Laterolateral duodenum enteroanastomosis was performed with proximal jejunum and gastroenteroanastomosis with the distal loop of the small intestine at 90 cm from the Treitz angle, and a termino lateral enteroanastomosis between food and the biliary loop at 20 cm from the gastroenteroanastomosis. Clinical Discussion: This report presents a new surgical technique for patients with penetrating duodenal trauma associated with liver and intestinal injuries, to avoid the need for more complex procedures. In addition, it demonstrates postoperative management of complications, including confection of the enteroatmospheric fistula for feeding. Conclusion: The technique described in this article proved to be a good option for treating these lesions, as evidenced by optimal postoperative results. (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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