Pancreatic fistula after intra-abdominal abscess drainage tube wash-Healing.doc

 PAGE \* MERGEFORMAT 8 Pancreatic fistula after intra-abdominal abscess drainage tube wash-Healing [Keywords:] pancreatic fistula; abscess; wash Pancreatic fistula is trauma, hemorrhagic necrotizing pancreatitis or pancreatic surgery due to complications, once the merger intra-abdominal abscess, its treatment very difficult. In 2007, the hospital treated two cases, after washing with the drainage tube accompanied by anti-infective therapy, inhibit pancreatic secretion, intravenous high nutritional support treatment were cured are now combined treatment of patients report the following conclusions: A clinical data Case 1, male, aged 48, admitted before the 8 h, abdominal kicked by horses, abdominal pain after injury, 2 h after the abdominal pain, diffuse abdominal wide. Palpation, T: 37.8 ℃ , P: 96 times / min, R: 24 times / min, BP: 14/10 kPa, abdominal Xiphoid-visible, a diameter of about 15 cm circular ecchymosis, full abdominal tenderness , anti-rebound tenderness and muscle tension, shifting dullness positive weaken bowel sounds, abdominal Li-bit X-ray film showed left subphrenic free gas, abdominal wear out of 5 ml yellow turbid liquid, WBC: 16.2 * 109 / L, emergency in anesthesia laparotomy, intraoperative see the level of the sections of the duodenum 2 cm gap, pancreatic head contusion stasis edema, a large number of intra-abdominal exudate and purulent discharge, patients will duodenum laceration suture repair, gastrojejunostomy, common bile duct ‘T’ tube drainage, and in the duodenum repair and pelvic retroperitoneal space at the set tube 1, after the first 3 days high fever, T: 39 ℃ , a day out from the abdominal drainage tube to clarify and purulent fluid up to 300 ml, drainage fluid amylase measured 2 030 U, microscopic white blood cells and pus cell filled with vision, through the gastric and duodenal decompression tube into the United States Lan observation, to exclude duodenal fistula and gastrojejunostomy anastomotic leakage, color Doppler