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duodenal trauma

Arulselvi Subramanian, Venencia Albert, Biplab Mishra, Shilpi Sanoria, Ravindra Mohan Pandey
BACKGROUND: The literature suggests an association of pancreatic enzymes with systemic inflammation resulting in secondary organ injury and dysfunction following trauma. Elevation in serum enzymes may not always be predictive of pancreatic disease, and can reflect extra pancreatic production. OBJECTIVES: This study was conducted to evaluate the rise in serum pancreatic enzyme levels with the incidence of organ failure following trauma. PATIENTS AND METHODS: A retrospective review was performed on critically injured patients from December 2009 to March 2010...
May 2016: Trauma Monthly
Anjan Kumar Dhua, Manoj Joshi
Isolated duodenal perforation (IDP) in pediatric trauma is rarely reported. Since most of the children with blunt trauma are managed expectantly, timely diagnosis is imperative to avoid morbidity and mortality. We report a case of IDP and emphasize on certain specific clinical features indicating possibility of duodenal injury. We also stress upon the role of early contrast-enhanced computerized tomography (CECT) in such cases.
2015: Burns and trauma
F Quadrozzi, P Favoriti, M Favoriti, G Cofini
Intra-thoracic herniation of abdominal organs following diaphragmatic rupture represents an unusual clinical occurrence with great diagnostic difficulty. The authors present a case of right diaphragmatic rupture related to peritonitis due to perforated duodenal ulcer in previous (1 year before) thoraco-abdominal trauma with complete intra-thoracic herniation of the liver, gallbladder, ascending and transverse colon and lung collapse. The preoperative diagnosis has been based on clinical, chest X-ray, and ultrasound examination...
March 2016: Il Giornale di Chirurgia
Yavuz Poyrazoglu, Kazim Duman, Ali Harlak
Complex anatomical relation of the duodenum, pancreas, biliary tract, and major vessels plays to obscure pancreaticoduodenal injuries. Causes of pancreaticoduodenal injuries are blunt trauma (traffic accidents, sport injuries) in 25 % of cases and penetrating abdominal injuries (stab wounds and firearm injuries) in 75 % of cases. Duodenal injuries are reported to occur in 0.5 to 5 % of all abdominal trauma cases and are observed in 11 % of abdominal firearm wounds, 1.6 % of abdominal stab wounds, and 6 % of blunt trauma...
June 2016: Indian Journal of Surgery
Nawal Kishore Jha, Sanjay Kumar Yadav, Rajshekhar Sharma, Dipendra Kumar Sinha, Sandip Kumar, Marshal Daud Kerketta, Mini Sinha, Abhinav Anand, Anjana Gandhi, Satish Kumar Ranjan, Jitin Yadav
OBJECTIVE: To determine the presentation, anatomical distribution, diagnostic method, management and outcome of hollow viscus injury (HVI) from blunt abdominal trauma. METHODS: This  was  a  retrospective  cross-ecnal  study  including  patients  with  blunt  abdominal  trauma leading to HVI admitted at Rajendra Institute of Medical Sciences, Ranchi, over a period of 4.5 years (January 2009 to July 2014). Data were retrieved from patients' medical records...
October 2014: Bulletin of Emergency and Trauma
Michael F Nentwich, M Reeh, F G Uzunoglu, K Bachmann, M Bockhorn, J R Izbicki, Y K Vashist
OBJECTIVE: To retrospectively assess the frequency and indications for emergency pancreatoduodenctomies in a tertiary referral center. METHODS: Pancreatoduodenectomies between January 2005 and January 2014 were retrospectively assessed for emergency indications defined as surgery following unplanned hospital admission in less than 24 h. Data on indications and on the intraoperative as well as the post-operative course were collected. RESULTS: Out of 583 pancreatoduodenectomies during the interval, a total of 10 (1...
September 2016: World Journal of Surgery
E Girard, J Abba, C Arvieux, B Trilling, P Y Sage, N Mougin, S Perou, P Lavagne, C Létoublon
INTRODUCTION: Pancreatic trauma (PT) is associated with high morbidity and mortality; the therapeutic options remain debated. MATERIAL AND METHODS: Retrospective study of PT treated in the University Hospital of Grenoble over a 22-year span. The decision for initial laparotomy depended on hemodynamic status as well as on associated lesions. Main pancreatic duct lesions were always searched for. PT lesions were graded according to the AAST classification. RESULTS: Of a total of 46 PT, 34 were grades II or I...
August 2016: Journal of Visceral Surgery
Mohsen Kolahdoozan, Akbar Behdad, Mehrdad Hosseinpour, Samin Behdad, Mohammad Taghi Rezaei
BACKGROUND: The liver is the most commonly injured organ in blunt abdominal trauma. Although major hepatic bleeding may be partially controlled with portal triade clamping (the Pringle's maneuver), continuous prolonged clamping results in liver ischemia. OBJECTIVES: The purpose of this study was to determine the safe time of Pringle maneuver based on pathologic changes of liver in rabbit models. MATERIALS AND METHODS: In an experimental study, 20 New-Zealand white rabbits were selected...
December 2015: Archives of Trauma Research
A Celik, E Altinli, N Koksal, E Onur, A Sumer, M Ali Uzun, M Kayahan
INTRODUCTION: Duodenal injuries are uncommon and are associated with significant morbidity and mortality due to delayed diagnosis (in the case of blunt trauma) or associated major vascular injuries (in the case of penetrating trauma). Isolated blunt injuries may have a subtle clinical presentation, and are particularly difficult to diagnose when the perforation is located in the retroperitoneal part of the duodenum. MATERIALS AND METHODS: This paper presents in company with three cases of successfully treated isolated duodenal injuries due to blunt trauma, focusing on with their preoperative diagnosis, surgical management and final out comes...
December 2010: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Rao R Ivatury, Ajai K Malhotra, Michel B Aboutanos, Therese M Duane
Duodenal injuries are uncommon injuries but are associated with significant morbidity and mortality from a delayed diagnosis in the case of blunt trauma and associated major vascular injuries in penetrating trauma. A simplistic approach with primary repair or resection and anastomosis is ideal for the vast majority. Complex procedures such as pyloric exclusion with or without gastrojejunostomy may be indicated for delayed treatment or severe, high-grade combined pancreato-duodenal injuries. A high index of suspicion and a judicious treatment plan based on a careful consideration of all the available options are crucial for optimal outcome...
June 2007: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Konstantinos Spaniolas, George C Velmahos
Following injuries to the pancreas and duodenum (PDI) patients often present in extremis and undergo immediate laparotomy for hemodynamic instability and peritoneal signs. Nonoperative management (NOM) may be offered in selected patients with lowgrade injuries. Precise mapping of the injury, most commonly by computed tomography, is a prerequisite for NOM because clinical symptomatology can be variable and misleading. Additionally, delaying the treatment of PDI that should be corrected surgically may lead to significant complications...
June 2007: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Roland N Dickerson, Johnathan R Voss, Thomas J Schroeppel, George O Maish, Louis J Magnotti, Gayle Minard, Martin A Croce
OBJECTIVE: The aim of this study was to evaluate the feasibility of enteral nutrition (EN) for critically ill trauma patients with severe traumatic duodenal injuries who received placement of concurrent decompressing and feeding jejunostomies. METHODS: Adult patients admitted to the trauma intensive care unit from January 2010 to December 2013, given concurrent afferent decompressing and efferent feeding jejunostomies for severe duodenal injury and provided EN or parenteral nutrition (PN), were retrospectively evaluated...
March 2016: Nutrition
Klaas Albert Hartholt, Jan Willem T Dekker
Blunt abdominal trauma may cause severe intra-abdominal injuries, while clinical findings could be mild or absent directly after the trauma. The absence of clinical findings could mislead physicians into underestimating the severity of the injury at the primary survey, and inevitably leads to a delay in the diagnosis. The Blunt Abdominal Trauma in Children (BATiC) score may help to identify children who are at a high risk for intra-abdominal injuries in an early stage and requires additional tests directly...
2015: BMJ Case Reports
Turan Calhan, Abdurrahman Sahin, Resul Kahraman, Barış Soydaş, Ali Tosun, Egemen Cebeci
Duodenal intramural hematoma (DIH) usually occurs in childhood and young adults following blunt abdominal trauma. It may also develop in the presence of coagulation disorders and may rarely be an iatrogenic outcome of endoscopic procedures. Management of DIH is usually a conservative approach. A case of intramural duodenal hematoma that developed following endoscopic epinephrine sclerotherapy and/or argon plasma coagulation and that was nonresponsive to conservative therapy in a patient with chronic renal failure who died from sepsis is being discussed in this report...
2015: Case Reports in Gastrointestinal Medicine
Ajai Malhotra, Walter L Biffl, Ernest E Moore, Martin Schreiber, Roxie A Albrecht, Mitchell Cohen, Martin Croce, Riyad Karmy-Jones, Nicholas Namias, Susan Rowell, David V Shatz, Karen J Brasel
No abstract text is available yet for this article.
December 2015: Journal of Trauma and Acute Care Surgery
Francesco D'Arpa, Giuseppina Orlando, Roberta Tutino, Giuseppe Salamone, Emanuele Onofrio Battaglia, Gaspare Gulotta
The duodenal injuries occur in the 3-5% of blunt abdominal traumas. The isolated intramural duodenal hematoma is a very rare lesion. An early diagnosis and an adequate therapy are crucial because a delay, beyond 24 hours, increases the mortality from the 11% to 40%. However, diagnosis is often hindered by a lack of specific symptoms. We report a case of a 21 years-old man with an intestinal obstruction from isolated intramural duodenal hematoma occurred after a blunt abdominal trauma in a sport competition...
2015: Annali Italiani di Chirurgia
Thomas J Schroeppel, Kashif Saleem, John P Sharpe, Louis J Magnotti, Jordan A Weinberg, Peter E Fischer, Martin A Croce, Timothy C Fabian
BACKGROUND: Multiple techniques are used for repair in duodenal injury ranging from simple suture repair for low-grade injuries to pancreaticoduodenectomy for complicated high-grade injuries. Drains, both intraluminal and extraluminal, are placed variably depending on associated injuries and confidence with the repair. It is our contention that a simplified approach to repair will limit complications and mortality. The major complication of duodenal leak (DL) was the outcome used to assess methods of repair in this study...
March 2016: Journal of Trauma and Acute Care Surgery
Walid Elmoghazy, Islam Noaman, Ahmed-Emad Mahfouz, Ahmed Elaffandi, Hatem Khalaf
INTRODUCTION: Intramural duodenal hematoma (IDH) is a rare pathological entity that occurs as a complication of trauma, pancreatitis, peptic ulcer disease or endoscopic biopsy procedures. In this report, we present a case of IDH related to a duodenal diverticulum that was complicated by intra-abdominal bleeding and peritonitis. PRESENTATION OF CASE: We report a 31-year old male who presented with pancreatitis that was complicated with IDH, as diagnosed using endoscopy and CT scan of the abdomen...
2015: International Journal of Surgery Case Reports
Dominic M Barfield, Michael S Tivers, Matthew Holahan, Kristin Welch, Arthur House, Sophie E Adamantos
OBJECTIVE: To describe the clinical characteristics of recurrent septic peritonitis in dogs. DESIGN: Multicenter retrospective observational study. ANIMALS: Client-owned dogs with recurrent septic peritonitis. SETTING: Three university emergency and referral hospitals. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Medical records from 3 veterinary university teaching hospitals were reviewed and data were collected using a standardized data collection sheet for all cases of septic peritonitis during the study period (2000-2011)...
March 2016: Journal of Veterinary Emergency and Critical Care
Matthew Bradley, Brandon Bonds, David Dreizin, Katharine Colton, Kathirkamanthan Shanmuganathan, Thomas M Scalea, Deborah M Stein
INTRODUCTION: Clear signs of duodenal injury (DI) such as pneumoperitoneum and/or oral contrast extravasation mandate laparotomy. Management when computed tomography (CT) reveals indirect evidence of DI namely duodenal hematoma or periduodenal fluid is unclear. We evaluated the utility of indirect signs to identify DI and the success of expected management, hypothesizing patients with indirect evidence of DI on CT can be safely managed non-operatively. METHODS: We retrospectively reviewed patients with a computed tomography (CT) scan with periduodenal hematoma or periduodenal fluid treated between January 2003 and January 2013 at a level 1 Trauma Center...
January 2016: Injury
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