This is an automatically translated article.
Injury to the duodenum is one of the extremely dangerous abdominal trauma, causing a very serious infection behind the peritoneal cavity. Because duodenal injury or duodenal rupture is not easy to detect clinically, patients need to be extremely attentive to be able to recognize and treat early.
1. Duodenal injury
The duodenum is defined as the first part of the small intestine in the human body with a length of nearly 25cm. The duodenum begins in the pylorus of the stomach and ends at the angle formed by the duodenum and jejunum. The duodenum is considered one of the most important organs in the digestive tract. The most important function of the duodenum is to store pancreatic juice and bile from the major and minor papillae into the duodenum. The duodenum is the organ that transports most of the fluid in the digestive system, about 10 liters per day, including fluids such as pancreatic juice, bile, gastric juice, etc., not counting the fluid taken by food. The most important part is the descending duodenum, which is the location where the duodenum adheres to the pancreas and has the organization of the large and small duodenal papilla here, so when the duodenal injury is in this position, it will be very serious. .
Tá tràng là một trong những cơ quan quan trọng trong đường tiêu hóa
The duodenum is an organ located behind the peritoneum, surrounding the first part of the pancreas and crossing the spine, so the condition for a duodenal injury or duodenal rupture to occur usually must originate from a forceful impact. very big. For this reason, when duodenal rupture occurs, patients often have some other abdominal trauma or extra-abdominal trauma, causing some complications of blunt abdominal trauma, such as abdominal bleeding, peritonitis. , traumatic brain injury ... Therefore, the symptoms of these comorbid conditions can make it very difficult for the physician to diagnose a patient with a duodenal injury.
2. Is duodenal injury dangerous?
Duodenal trauma is an extremely dangerous disease because it is difficult to diagnose. As mentioned above, because duodenal rupture can be masked by symptoms of other comorbid conditions, the diagnosis is difficult and easy to miss clinically, especially duodenal rupture. on the back because it will lead to a very serious infection. For this reason, during surgery, if a retroperitoneal clot is found, it should be carefully examined, especially when the blood is mixed with blue color from the bile, there is a possibility that duodenal rupture has occurred. , need to be handled promptly.
Xuất hiện huyết khối sau phúc mạc có thể là nguy cơ vỡ tá tràng
In some cases, if duodenal injury occurs independently without any pathology, it is difficult to recognize, or it takes a long time for the symptoms of duodenal rupture to manifest. clinical. The cause of this phenomenon is explained that when duodenal rupture occurs in the patient's body, after many hours, the duodenal fluid begins to flow into the abdomen, so peritonitis occurs. long after duodenal rupture, the signs of this phenomenon are difficult to recognize easily and quickly. Therefore, often duodenal injury will be detected during surgery through the symptom of a blue hematoma.
Because of late detection, easy to miss clinically and during surgery, duodenal rupture leaves many dangerous complications, even leading to death. Some studies in the world suggest that the rate of complications after surgical treatment for duodenal injury ranges from 17.6% to 46.6%, the mortality rate of this pathology is more than 20%.
The cause of dangerous complications after surgery for duodenal injury is explained as follows. The duodenum is known as the first organ to perform the function to ensure the normal digestive process. in the body, so the duodenum contains activated pancreatic enzymes that can interfere with the wound healing process in the duodenum. Therefore, when suturing the duodenum with normal sutures like other surgeries, it is very easy to have fistulas as well as to break the mouth of the sutures after surgery.
Rất dễ có hiện tượng rò hay bục chỉ sau khi mổ chấn thương tá tràng
To overcome this situation, some commonly used methods to surgically treat duodenal rupture include suturing and anastomosis of the duodenum, duodenal suture and gastric drainage, and simultaneous gastrectomy. Besides, it will be combined with gallbladder drainage to handle peritonitis. Today, more modern techniques are also born to treat duodenal rupture more effectively and ensure the reduction of serious complications, which is laparoscopic surgery to support duodenal-pancreatectomy. Also known as Whipple surgery with the advantage of being less invasive and safer than the traditional open surgery method.
Injury to the duodenum is classified as a dangerous abdominal injury, requiring emergency care as soon as possible. Because of the anatomical structures and physiological features of the duodenum, the diagnosis and treatment of duodenal rupture are difficult and can cause many other complications. Therefore, it is necessary to observe and closely monitor the symptoms of this dangerous disease to bring the patient to a medical facility in the most urgent case.
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