Table 1 Clinical data of four children with traumatic duodenal rupture
From: Diagnosis and treatment of traumatic duodenal rupture in children
Case | Age (years) | Sex | Cause of injury | Clinical manifestations | Abdominal tenderness | Laboratory examination | Radiography (free air under the diaphragm) | B-mode ultrasound (effusion) | CT | Treatments in another hospital | Time to operation in our hospital after injury (days) |
|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 1.5 | Male | Oxygen cylinder crush | Abdominal pain | + | + | - | + | + | No | 2 |
2 | 3 | Male | Physically injured by another person | Abdominal pain, nausea, vomiting, sluggishness | + | + | + | + | + | Anti-shock, ventilator-assisted ventilation | 3 |
3 | 3 | Female | Motor vehicle accident | Abdominal pain | + | + | - | + | + | Exploratory laparotomy on the first day after injury | 2 |
4 | 9 | Male | Fall from bike | Abdominal pain, nausea, vomiting | + | + | - | + | + | Exploratory laparotomy + right ureteral stent implantation on the day of injury; exploratory laparotomy + duodenal repair + three-tube drainage on the next day; intestinal fistula and ureteral fistula occurred after surgery; conservative treatment for 42 days | 46 |
Case | Age (years) | Sex | Rupture site | Concomitant injury | Grades of duodenal injury | Surgical approach | Postoperative complications and treatment | Hospital stay (days) | Results |
|---|---|---|---|---|---|---|---|---|---|
1 | 1.5 | Male | Complete rupture at level of duodenum | No | III | Duodenostomy + gastrostomy + jejunostomy | No | 28 | Cured |
2 | 3 | Male | Perforation of the posterior wall at junction of duodenum and jejunum, 8 mm in diameter | No | II | Repair of perforation of posterior duodenal wall | No | 30 | Cured |
3 | 3 | Female | Complete rupture at beginning of horizontal section of duodenum | No | III | Duodenostomy + jejunostomy | Fungal infection, drug combination; anastomotic stenosis, endoscopic anastomotic dilation | 49 | Cured |
4 | 9 | Male | Junction of descending section and horizontal section of duodenum completely ruptured with poor blood supply | Rupture of the right ureter | V | Duodenostomy + gastrostomy + jejunostomy | Multidrug-resistant bacterial and fungal infections, symptomatic and combination medication; poor wound healing, wound care; intestinal fistula, conservative treatment | 86 | Cured |