医学
迟钝的
外科
创伤中心
小儿外伤
钝伤
损伤严重程度评分
腹部外伤
损伤控制
回顾性队列研究
伤害预防
毒物控制
急诊医学
作者
Katherine Smiley,Tiffany Wright,Sean C. Skinner,Joseph A. Iocono,John M. Draus
出处
期刊:ISRN Pediatrics (Print)
[Hindawi Limited]
日期:2012-11-05
卷期号:2012: 1-4
被引量:5
摘要
Background. Operative blunt duodenal trauma is rare in pediatric patients. Management is controversial with some recommending pyloric exclusion for complex cases. We hypothesized that primary closure without diversion may be safe even in complex (Grade II-III) injuries. Methods. A retrospective review of the American College of Surgeons' Trauma Center database for the years 2003-2011 was performed to identify operative blunt duodenal trauma at our Level 1 Pediatric Trauma Center. Inclusion criteria included ages <14 years and duodenal injury requiring operative intervention. Duodenal hematomas not requiring intervention and other small bowel injuries were excluded. Results. A total of 3,283 hospital records were reviewed. Forty patients with operative hollow viscous injuries and seven with operative duodenal injuries were identified. The mean Injury Severity Score was 10.4, with injuries ranging from Grades I-IV and involving all duodenal segments. All injuries were closed primarily with drain placement and assessed for leakage via fluoroscopy between postoperative days 4 and 6. The average length of stay was 11 days; average time to full feeds was 7 days. No complications were encountered. Conclusion. Blunt abdominal trauma is an uncommon mechanism of pediatric duodenal injuries. Primary repair with drain placement is safe even in more complex injuries.
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