Alternativa quirúrgica de reparación duodenal en pediatría (presentación de caso), Hospital Infantil Dr. Robert Reid Cabral (HIRRC), República Dominicana
Files
Date
Subject
Duodenal lesions
duodenal trauma
duodenal repair
gastrojejunostomy
pediatric techniques
lesión duodenal
trauma duodenal
reparación duodenal
gastroyeyunostomía
técnicas en pediatría
duodenal trauma
duodenal repair
gastrojejunostomy
pediatric techniques
lesión duodenal
trauma duodenal
reparación duodenal
gastroyeyunostomía
técnicas en pediatría
Language:
Journal Title
Journal ISSN
Volume Title
Publisher
Intituto Tecnológico de Santo Domingo (INTEC)
Introducción: el trauma cerrado de abdomen en pediatría ocasiona lesión de órganos abdominales en 8-12 % de la población, siendo lesiones duodenales solo el 10 % de estas, por lo que son poco frecuentes en pediatría. La principal causa de lesión duodenal se relaciona con abuso infantil, siendo los accidentes de vehículos de motor el segundo mecanismo más común. Cuando se trata de lesiones no destructivas, la reparación primaria del duodeno es razonable. Sin embargo, las lesiones destructivas ameritan estrategias de reparación más complejas.
Material y Método: presentamos paciente masculino de tres años edad con lesión duodenal grado III en ángulo duodenoyeyunal, la misma fue intervenida inicialmente mediante anastomosis primaria, presentado posterior dehiscencia. En su segunda intervención se realiza cierre duodenal distal y anastomosis gastroyeyunal, favoreciendo flujo retrogrado de vías biliares a estómago, con adecuada evolución.
Conclusión: existen múltiples abordajes quirúrgicos, los cuales representan aun hoy gran morbilidad. El cierre duodenal con la posterior decisión de cómo derivar las vías biliares, es probablemente el mayor desafío. Se plantea la posibilidad del cierre duodenal distal a las vías biliares, con drenaje retrógrado. Por lo cual la gastroyeyunostomía es una técnica alternativa en pediatría en la reparación de lesiones complejas del duodeno.
Introduction: Blunt trauma of the abdomen in pediatrics causes injury to abdominal organs in 8-12 % of the population, with duodenal injuries being only 10 % of these, which is why they are rare in pediatrics. The main cause of duodenal injury is related to childhood abuse, with motor vehicle accidents being the second most common mechanism. When it comes to nondestructive injury, primary duodenal repair is reasonable. However, destructive injuries warrant more complex repair strategies. Material and Method: We present a 3-year-old male patient with a grade III duodenal injury at the duodenojejunal angle, which was initially operated on by means of a primary anastomosis, with subsequent dehiscence. In his second operation, a distal duodenal closure and a gastrojejunal anastomosis were performed, favoring retrograde flow of the bile ducts to the stomach, with adequate evolution. Conclusion: There are multiple surgical approaches, which still represent great morbidity today. Duodenal closure with the subsequent decision on how to bypass the bile ducts is probably the greatest challenge. The possibility of duodenal closure distal to the bile ducts, with retrograde drainage, is raised. Therefore, gastrojejunostomy is an alternative technique in pediatrics for the repair of complex duodenal injuries.
Introduction: Blunt trauma of the abdomen in pediatrics causes injury to abdominal organs in 8-12 % of the population, with duodenal injuries being only 10 % of these, which is why they are rare in pediatrics. The main cause of duodenal injury is related to childhood abuse, with motor vehicle accidents being the second most common mechanism. When it comes to nondestructive injury, primary duodenal repair is reasonable. However, destructive injuries warrant more complex repair strategies. Material and Method: We present a 3-year-old male patient with a grade III duodenal injury at the duodenojejunal angle, which was initially operated on by means of a primary anastomosis, with subsequent dehiscence. In his second operation, a distal duodenal closure and a gastrojejunal anastomosis were performed, favoring retrograde flow of the bile ducts to the stomach, with adequate evolution. Conclusion: There are multiple surgical approaches, which still represent great morbidity today. Duodenal closure with the subsequent decision on how to bypass the bile ducts is probably the greatest challenge. The possibility of duodenal closure distal to the bile ducts, with retrograde drainage, is raised. Therefore, gastrojejunostomy is an alternative technique in pediatrics for the repair of complex duodenal injuries.
Description
Type
info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
info:eu-repo/semantics/publishedVersion
Source
Science and Health; Vol. 5 No. 1 (2021): Science and Health, january-april; 129-136
Ciencia y Salud; Vol. 5 Núm. 1 (2021): Ciencia y Salud, enero-abril; 129-136
2613-8824
2613-8816
10.22206/cysa.2021.v5i1
Ciencia y Salud; Vol. 5 Núm. 1 (2021): Ciencia y Salud, enero-abril; 129-136
2613-8824
2613-8816
10.22206/cysa.2021.v5i1