Clinical diagnosis and treatment of duodenal injury.docVIP

 PAGE \* MERGEFORMAT 10 Clinical diagnosis and treatment of duodenal injury [Keywords:] diagnosis and treatment of duodenal injury Mostly in the retroperitoneal duodenum, a low incidence of injury, damage found in the duodenum more the second, three. Duodenal bulb and descending part of the Department of the Ministry and the level of all the retroperitoneal are covered, so where injury, early symptoms and signs often more subtle, more difficult the diagnosis and treatment, mortality and higher incidence of complications. if accompanied by the pancreas and adjacent large blood vessels and other organ damage, mortality higher. Therefore, careful and comprehensive clinical examination must be addressed early. 1 Clinical data 1.1 General Clinical duodenal injury data collection, 20 patients, 17 males and 3 females, the youngest 15 years old, maximum of 50 years, mean age 32 years, 18 cases of blunt trauma, 2 cases of open injury. The causes of injury: traffic injuries in 5 cases, 3 cases of crush injury, fall injury in 4 cases, blunt injury in 3 cases, 5 cases of needlestick injuries. from injury to operation time 1 ~ 48h, of which more than 24h in 3 cases. 1.2 occurred in the clinical part of the abdominal cavity may be due to pancreatic juice and bile into the abdominal cavity and cause peritoneal irritation sign early. Closed injury of retroperitoneal duodenal rupture due to early symptoms, signs and more obvious. Then can have severe peritoneal After infection, persistent pain in the right upper abdomen or waist and progressive increase, to the right shoulder and right testicular diffuse. 1.3 Check the duodenal injury secondary abdominal paracentesis or lavage are mostly negative, even be out pale yellow liquid bile. X ray chest and abdominal plain film examination or if found in the left subphrenic gas accumulation around the right kidney, psoas muscle shadows disappear or fuzzy, scoliosis, then the diagnosis. gastrointestinal b