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DOI: 10.1055/s-2003-38539
© Georg Thieme Verlag Stuttgart · New York
Erfolgreiche Organerhaltung nach kompletter Pankreasruptur und subtotalem Duodenalabriss durch stumpfes Bauchtrauma im Kindesalter: Ein Fallbericht
Successful Repair of Complete Pancreatic Rupture and Subtotal Duodenal Avulsion after Blunt Abdominal Trauma in Childhood - a Case ReportPublication History
Publication Date:
15 April 2003 (online)
![](https://www.thieme-connect.de/media/zblchir/200303/lookinside/thumbnails/10.1055-s-2003-38539-1.jpg)
Zusammenfassung
Wir berichten über einen 12-jährigen Jungen, der sich durch Sturz auf einen Fahrradlenker ein epigastrisches stumpfes Bauchtrauma zuzog mit Zeichen der Hohlorganperforation und stark erhöhten Pankreasenzymwerten. Bei der Notfallaparotomie wurden eine komplette Ruptur des Pankreashalses und ein nahezu totaler Abriss des Duodenums postpylorisch vorgefunden (Grad IV nach Lucas). Die Rekonstruktion bestand aus End-zu-End-Anastomosierung des proximalen Duodenums, distalem Verschluss des Pankreaskopfes und interner Ableitung des linksseitigen Pankreas in eine nach Roux-Y ausgeschaltete Dünndarmschlinge. Der postoperative Verlauf war unauffällig. Für die seltenen pankreatikoduodenalen Verletzungen sind nur individuelle, vom Verletzungsausmaß abhängige chirurgische Konzepte möglich. Pankreasresektionen sollten vermieden werden.
Abstract
We report the case of a 12-year-old boy who presented after a bicycyle accident with handlebar injury of the epigastrium with clinical signs of hollow visceral injury and elevated pancreatic enzymes. Upon emergency laparotomy, a complete rupture of the pancreatic isthmus and a nearly total transsection of the postpyloric duodenum were encountered (Grade IV according to Lucas). Reconstruction consisted of reanastomosis of the proximal duodenum, closure of the distal end of the pancreatic head and internal drainage of the left pancreas into a Roux-en-Y jejunal loop. The postoperative course was uneventful. For rare traumatic pancreaticoduodenal lesions only individual surgical concepts are promising depending on the extent of damage. However, effort should be made to preserve as much pancreatic tissue as possible.
Schlüsselwörter
Pankreasverletzung - Duodenum - Kinder
Key words
Pancreatic injury - duodenum - children
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