| Autor: |
Nasser, M. Fawzi, Sheikh, Muddaser M., Al-Amry, Sultan Abdallah, El-Sayed, Essam, Al-Khalifa, Yasser, Mostafa, Medhat, Al-Shahrani, Abdul Aziz Ayed, Dauda, Bawa D., Al-Ghamdi, Saeed Abdallah, Khan, Saleem Abdul Sattar |
| Předmět: |
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| Zdroj: |
Pakistan Journal of Surgery; Jan-Mar2017, Vol. 33 Issue 1, p96-100, 5p |
| Abstrakt: |
Injury to duodenum and pancreas is rare because of there safe retroperitoneal anatomical position. The injury to duodenum and pancreas initially present little symptoms therefore both pre and intra-operative detection of injury can be difficult. Also majority of the Pancreaticoduodenal injuries although are very rare but have a significant morbidity and mortality. Both Duodenum and pancreas have safe retro-peritoneal location, therefore sign and symptoms patients are subtle therefore difficult to diagnose also these patients have multiple associated injuries and are hemodynamically unstable which can be a cause of early mortality in these cases. We present case report of 23 years old male who presented to a peripheral Hospital with a history of gunshot abdomen with wound of entry in epigastrium and wound of exit on right site of abdomen posteriorly, he underwent laparotomy at peripheral hospital, the findings documented at laparotomy was 8 cms tear in right lobe of liver, two tears were found in transverse colon which were repaired and proximal colon was brought out as loop colostomy. Two drains were placed in morrisons pouch and pelvis. Patient was referred to King Abdullah Hospital Bisha as patient was discharging copious biliary fluid in both drains. The Patient was resuscitated and underwent CT abdomen with Gastrografin oral contrast which was suggestive of Duodenal tear at the second and 3rd part of Duodenum which was repaired in 2 layers with Nasogastric tube placed, tube gastrostomy and feeding Jejunostomy performed. Patient had an uneventful recovery. Oral fluid started on 6th post-operative day. And tube gastrostomy was removed on 10th post-operative day. Conclusion: Duodenal injuries are rare due to safe anatomical position of Duodenum. The clinician should have high index of suspision when ever he is dealing with road traffic accident, seat belt injuries and gunshot abdomen to diagnose such injury, so that timely treatment can be off ered to patient to avoid morbidity and mortality. [ABSTRACT FROM AUTHOR] |
| Databáze: |
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