scholarly journals Uždaras izoliuotas ketvirto laipsnio kasos sužalojimas: klinikinis atvejis

2008 ◽  
Vol 6 (1) ◽  
pp. 0-0
Author(s):  
Tomas Vaitoška ◽  
Lina Praleikienė ◽  
Juozas Stanaitis ◽  
Raimundas Lunevičius
Keyword(s):  
Case Report ◽  
Surgical Intervention ◽  
Pancreatic Injury ◽  
Distal Segment ◽  
Care Hospital ◽  
Pancreatic Trauma ◽  
Rare Type ◽  
Blunt Pancreatic Trauma ◽  
Vilnius University ◽  
Surgery Center

Tomas Vaitoška, Lina Praleikienė, Juozas Stanaitis, Raimundas LunevičiusVilniaus universiteto Gastroenterologijos, nefrourologijos ir chirurgijosklinikos Bendrosios chirurgijos centras, Vilniaus universitetinėgreitosios pagalbos ligoninė, Šiltnamių g. 29, LT-04130 VilniusEl paštas: [email protected] Įvadas / tikslas Uždaras izoliuotas IV laipsnio kasos sužalojimas yra retas net specializuotose skubią pagalbą dėl ūminių ligų ir traumų teikiančiose ligoninėse. Straipsnio tikslas – aprašyti tokį kasos sužalojimą patyrusio ligonio chirurginio gydymo taktikos, kai atliekama pankreatojejunostomija, variantą. Klinikinis atvejis Dėl viršutinės pilvo dalies potrauminio progresuojančio peritonito 33 metų stabilios hemodinamikos vyrui atlikta viršutinė vidurinė laparotomija. Operacijos metu nustatyta peripankreatinė hematoma ir jos priežastis – izoliuotas visiškas skersinis kasos plyšimas ties viršutinėmis pasaito kraujagyslėmis. Proksimalinis sužalotos kasos galas užsiūtas dviejų aukštų pavienėmis siūlėmis. Distalinė kasos dalis susiūta su tuščiąja žarna Roux-en-Y būdu, t. y. suformuota pankreatojejunostoma. Pilvo ertmė drenuota keturiais drenais. Pooperacinių komplikacijų nebuvo. Išvada Roux-en-Y būdu atlikta pankreatojejunostomija yra veiksminga operacija gydant neseniai patirtą uždarą izoliuotą IV laipsnio kasos sužalojimą. Pagrindiniai žodžiai: uždara kasos trauma, pankreatojejunostomija Blunt isolated grade IV injury of pancreas: a case report Tomas Vaitoška, Lina Praleikienė, Juozas Stanaitis, Raimundas LunevičiusVilnius University, General Surgery Center of Clinic of Gastroenterology,Nephrourology and Surgery, Vilnius University Emergency Hospital,Šiltnamių str. 29, LT-04130 Vilnius, LithuaniaE-mail: [email protected] Background / objective A blunt isolated grade IV pancreatic injury is a rare type of trauma even for a specialized emergency care hospital. The purpose of the article is to describe the surgical treatment of pancreatic trauma of this type when Roux-en-Y pancreatojejunostomy had been performed. Case report A male patient was hospitalized due to blunt abdominal trauma. The progress of peritonitis determined the surgical intervention. Laparotomy was performed, and grade IV traumatic laesion of the pancreas was confirmed. The proximal edge of the ruptured pancreas was sutured, and Roux-en-Y pancreatojejunostomy was performed for the distal segment of the pancreas. There were no postoperative complications. Conclusion Roux-en-Y pancreatojejunostomy is an efective operation in case of blunt isolated grade IV pancreatic injury. Keywords: blunt pancreatic trauma, pancreatojejunostomy

scholarly journals Surgical Intervention for Laimer’s Diverticulum, a Rare Type of Pharyngoesophageal Diverticulum: A Case Report

OTO Open ◽  
2019 ◽  
Vol 3 (2) ◽  
pp. 2473974X1984767 ◽  
Author(s):  
Naoto Ujiie ◽  
Yusuke Taniyama ◽  
Chiaki Sato ◽  
Takashi Kamei
Keyword(s):  
Case Report ◽  
Surgical Intervention ◽  
Rare Type

scholarly journals A case report on the usefulness of early endoscopic ultrasound (EUS)-guided transgastric internal stenting for severe blunt pancreatic trauma

Injury Extra ◽  
2014 ◽  
Vol 45 (9) ◽  
pp. 65-68
Author(s):  
Satoshi Iino ◽  
Masahiko Sakoda ◽  
Koji Minami ◽  
Kiyotsugu Hiwatashi ◽  
Hiroshi Kurahara ◽  
...  
Keyword(s):  
Case Report ◽  
Endoscopic Ultrasound ◽  
Pancreatic Trauma ◽  
Blunt Pancreatic Trauma

Fatal blunt pancreatic trauma secondary to assault and battery: a case report

2001 ◽  
Vol 115 (3) ◽  
pp. 162-164 ◽  
Author(s):  
C. Rougé-Maillart ◽  
A. Tracqui ◽  
M. C. Tortel ◽  
P. Pessaux ◽  
M. Penneau ◽  
...  
Keyword(s):  
Case Report ◽  
Pancreatic Trauma ◽  
Blunt Pancreatic Trauma ◽  
Assault And Battery

Imaging of Blunt Pancreatic Trauma: A Systematic Review

2020 ◽  
Vol 71 (3) ◽  
pp. 344-351 ◽  
Author(s):  
Devang Odedra ◽  
Vincent M. Mellnick ◽  
Michael N. Patlas
Keyword(s):  
Systematic Review ◽  
Keyword Search ◽  
Pancreatic Injury ◽  
Imaging Modalities ◽  
Primary Study ◽  
Separate Analysis ◽  
Pancreatic Trauma ◽  
Study Objective ◽  
Large Variability ◽  
Blunt Pancreatic Trauma

Purpose: Despite several published reports on the value of imaging in acute blunt pancreatic trauma, there remains a large variability in the reported performance of ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI). The purpose of this study is to present a systematic review on the utility of these imaging modalities in the acute assessment of blunt pancreatic trauma. In addition, a brief overview of the various signs of pancreatic trauma will be presented. Methods: Keyword search was performed in MEDLINE, EMBASE, and Web of Science databases for relevant studies in the last 20 years (1999 onward). Titles and abstracts were screened, followed by full-text screening. Inclusion criteria were defined as studies reporting on the effectiveness of imaging modality (US, CT, or MRI) in detecting blunt pancreatic trauma. Results: After initial search of 743 studies, a total of 37 studies were included in the final summary. Thirty-six studies were retrospective in nature. Pancreatic injury was the primary study objective in 21 studies. Relevant study population varied from 5 to 299. Seventeen studies compared the imaging findings against intraoperative findings. Seven studies performed separate analysis for pancreatic ductal injuries and 9 studies only investigated ductal injuries. The reported sensitivities for the detection of pancreatic injuries at CT ranged from 33% to 100% and specificity ranged from 62% to 100%. Sensitivity at US ranged from 27% to 96%. The sensitivity at MRI was only reported in 1 study and was 92%. Conclusion: There remains a large heterogeneity among reported studies in the accuracy of initial imaging modalities for blunt pancreatic injury. Although technological advances in imaging equipment would be expected to improve accuracy, the current body of literature remains largely divided. There is a need for future studies utilizing the most advanced imaging equipment with appropriately defined gold standards and outcome measures.

scholarly journals 1418 Non-Operative Versus Operative Management for Blunt Pancreatic Trauma in Adults: A Systematic Review of The Literature

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
N Al-Saadi ◽  
S Froghi
Keyword(s):  
Systematic Review ◽  
Management Strategy ◽  
Operative Management ◽  
Pancreatic Injury ◽  
Organ Injury ◽  
Pancreatic Trauma ◽  
Severity Of Injury ◽  
Increase Risk ◽  
Blunt Pancreatic Trauma ◽  
Accepted Practice

Abstract Aim Pancreatic injury, a rare consequence of blunt abdominal trauma, is associated with significant morbidity and mortality when the appropriate management is delayed. Due to the rarity of the injury, there is currently a lack of evidence to establish a treatment pathway for adults. The aim of this review was to compare outcomes following non-operative and operative management of adults who suffered blunt pancreatic trauma injuries. Method An electronic literature search was performed from 2008 to 2020. Studies pertaining to adults sustaining blunt pancreatic injuries, of all grades (I-V) of severity, according to the American Association for the Surgery of Trauma, were included. The primary outcome was mortality, whilst secondary outcomes were components of pancreas specific morbidity. 1501 studies were initially identified and screened, and 11 studies were included in the review. Results Qualitative analysis showed an increase risk of mortality with increased severity of injury, and in the operative group compared to non-operative group. All patients who were haemodynamically unstable underwent immediate operative management, whereas the management strategy for patients with haemodynamic stability differed between the studies and depended on either the grade of injury, presence of other organ injury, or failure of initial management strategy. Conclusions This systematic review largely reaffirmed accepted practice in determining operative versus non-operative treatment for blunt pancreatic injury. Larger institutional analyses are required to add strength to the evidence supporting non-operative management for grade III or IV injuries with appropriate monitoring and subsequent intervention if required.

Surgical treatment of alveolar echinococcosis: a single centre experience and systematic review of the literature

2019 ◽  
Vol 98 (4) ◽  
pp. 167-173
Keyword(s):  
Case Report ◽  
Echinococcus Multilocularis ◽  
Alveolar Echinococcosis ◽  
Lymphatic System ◽  
Surgical Intervention ◽  
Clinical Symptoms ◽  
Safety Margin ◽  
Surgical Removal ◽  
Single Centre Experience ◽  
Therapeutic Procedures

Introduction: Alveolar echinococcosis (AE) is a zoonosis caused by Echinococcus multilocularis. AE is primarily localised in the liver. Echinococcus multilocularis imitates tumour-like behaviour. It can metastasise through blood or lymphatic system to distant organs. Echinococcosis often remains asymptomatic due to its long incubation period and indistinct symptoms. Clinical symptoms are determined by the parasite’s location. Diagnosis of echinococcosis is based on medical history, clinical symptoms, laboratory tests, serology results, imaging methods and final histology findings. Surgical removal of the cyst with a safety margin, followed by chemotherapy is the therapeutic method of choice. Case report: We present a case report of alveolar echinococcosis in a thirty-year-old female patient in whom we surgically removed multiple liver foci of alveolar echinococcosis. The disease recurred after two years and required another surgical intervention. Conclusions: Alveolar echinococcosis is a disease with a high potential for a complete cure provided that it is diagnosed early and that the recommended therapeutic procedures are strictly adhered to.

Diagnosis and Management of Blunt Pancreatic Trauma in Children

2010 ◽  
Vol 10 (2) ◽  
Author(s):  
Edgars Zarembo ◽  
Arnis Engelis ◽  
Aigars Petersons
Keyword(s):  
Pancreatic Trauma ◽  
Diagnosis And Management ◽  
Blunt Pancreatic Trauma
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