The Analysis Of Diagnosis And Treatment For 16 Cases Of Duodenal Injuries

Objective To explore the diagnosis and treatment of closed and iatrogenic duodenal injuries,especially the delayed diagnosis of blunt duodenal injuries.To improve the recognition of this disease and provide help for clinical work by case analysis.Methods Clinical data of 16 cases of closed and iatrogenic duodenal injuries admitted to our hospital from January 2011 to February 2017 were retrospectively studied.Results The study included 9 males and 7 females with age ranging from 24 to 62 years.The causes of the injuries can be classified into closed injuries(62.5%)and iatrogenic injuries(37.5%).There were 8 cases in the descending part,5 cases in the horizontal part,1 cases in the ascending part and 2 cases in the descending and horizontal part?According to AAST grade,there were 3 cases of Grade 1,7 cases Grade 2,2 cases Grade 3,3 cases Grade 4,1 cases Grade 5.All patients were discharged from hospital after recovery in this 16 cases.Among the 9 cases who were performed with Surgical intervention at 24 hours after duodenal injury,3 cases were duodenal fistula,postoperative complication rates were 33.3%.Among the 6 cases who were underwent operations after 24 hours after injury,1 case was duodenal fistula,1 case was intestine obstruction,postoperative complication rates were 33.3% too.Between the 9 cases who did not indwelling Lishi catheter in the operation,4 case were duodenal fistula,1 case was intestine obstruction.The 6 cases who indwelling Lishi catheter in the operation did not have serious postoperative complications,such as duodenal fistula,intestine obstruction,and no death cases.get a good effect.Conclusion With the diversification of closed duodenal injuries,preoperative diagnosis is difficult.But iatrogenic diagnosis is easier,detection and treatment in time can reduce the incidence of complications.Effective perioperative combined with individualized treatment,delayed surgical diagnosis of duodenal injuries with a reasonable surgical procedure,no significant difference in the incidence of postoperative severe complications and non delayed diagnosis.Application of Lishi catheter can reduce the development of serious postoperative complication after duodenal operations.