| 篇名 |
Early Diagnosis of Duodenal Injury: A Review of Eleven Cases |
| 作者 |
Chih-Chieh Yang, Hsin-Chin Shih, Yu-Kuan Lin, Jer-Kan Wu, Tun-Jen Ko, Cheng-Hsi Su, Chen-Hsen Lee |
| 卷期/出版年月 |
31卷3期 (1998/6) |
| 頁次 |
187-191 |
| 摘要 |
Early diagnosis of duodenal trauma in injured patients is difficult. We reviewed our experience in the management of duodenal injury and searched for clinical implications enabling early diagnosis in the present study. The medical records of injured patients with duodenal trauma treated between January 1990 and December 1995 were reviewed. Their diagnosis, treatment, and outcome were analyzed. Eleven patients were enrolled; four with penetrating injuries and seven with blunt injuries. Three patients had delayed diagnosis (more than 24 hours after injury). Initial absence of overt peritoneal sign with negative sonogram or diagnostic peritoneal lavage (DPL) was the main cause of delay. The delayed cases were finally diagnosed by C'T scan for deteriorated abdominal condition or subsequent elevated amylase level. While CT scan found three duodenal injuries including one duodenal hematoma (3/3), sonogram missed five (5/10), and DPL missed one (1/2). In conclusion, initial absence of overt abdominal sign with negative sonogram or DPL will not exclude duodenal injury. High clinical suspicion even in trifling signs of abdomen, repeating amylase level, and complementary use of CT scan will decrease the catastrophe of delayed
diagnosis. |
| 關鍵詞 |
duodenal injury, sonogram, CT' scan, diagnostic peritoneal lavage |
| 分類 |
Original Articles |
