Generic placeholder image

New Emirates Medical Journal

Editor-in-Chief
ISSN (Online): 0250-6882

Case Report

Laparoscopic Repair of Near Complete Traumatic Duodenal Transaction in an Eight Years Old Child: A Case Report

Author(s): Iftikhar A. Jan*, Muna Ahmed Al Shehhi, Mokhtar Ali Hassan, Zahid Latif Saqi and Syed Faheem Ahmad

Volume 2, Issue 1, 2021

Published on: 08 October, 2020

Page: [68 - 71] Pages: 4

DOI: 10.2174/0250688201999201008161034

open_access

Abstract

Background: Traumatic duodenal perforation is a serious injury and is a result of major trauma and insult to the body. The management is difficult due to associated injuries and these children often need major resuscitation. The standard surgical treatment of traumatic duodenal perforation is laparotomy and repair of duodenal perforation. In children, laparoscopic repair of duodenal perforation is reported in only a few cases.

Case: A repair of a near-complete duodenal transaction is not reported in the pediatric population. Herein, we report a case of an eight years old child who had a road traffic accident, and sustained multiple injuries and duodenal perforation, as confirmed by radiological evaluation including CT abdomen. The child was resuscitated, and later laparoscopy was performed, which showed gross bruising of the abdominal wall and a nearcomplete transaction at the level of 3rd part of the duodenum.

Conclusion: Laparoscopic repair of the duodenum was performed using interrupted polyglycolic sutures. The child had a smooth post-op recovery and was discharged home in stable condition. At one-year follow-up, the child remained well and symptom-free. This case highlights the role of the safety of laparoscopic surgery in abdominal trauma and duodenal perforations.

Keywords: Laparoscopy, Duodenum, Trauma, Perforation, Transaction, Radiological evaluation.

[1]
Mandrioli M, Inaba K, Piccinini A, et al. Advances in laparoscopy for acute care surgery and trauma. World J Gastroenterol 2016; 22(2): 668-80.
[http://dx.doi.org/10.3748/wjg.v22.i2.668] [PMID: 26811616]
[2]
Trejo-Ávila ME, Valenzuela-Salazar C, Betancourt-Ferreyra J, Fernández-Enríquez E, Romero-Loera S, Moreno-Portillo M. Laparoscopic versus open surgery for abdominal trauma: A case-matched study. J Laparoendosc Adv Surg Tech A 2017; 27(4): 383-7.
[http://dx.doi.org/10.1089/lap.2016.0535] [PMID: 28253051]
[3]
Koto MZ, Matsevych OY, Mosai F, Balabyeki M, Aldous C. Laparoscopic management of retroperitoneal injuries from penetrating abdominal trauma in haemodynamically stable patients. J Minim Access Surg 2019; 15(1): 25-30.
[http://dx.doi.org/10.4103/jmas.JMAS_199_17] [PMID: 29483377]
[4]
Stringel Gustavo, Min Li Xu, Lopez Joseph. Minimally invasive surgery in pediatric trauma: One institution's 20-year experience. JSLS 2016; 20(1)
[5]
Hartholt KA, Dekker JW. Duodenal perforation as result of blunt abdominal trauma in childhood. BMJ Case Rep 2015; 2015: 2015.
[http://dx.doi.org/10.1136/bcr-2015-213330] [PMID: 26698210]
[6]
Jui-Ying Lee a, b, Yu-Tang Chang. Early laparoscopic repair for blunt duodenal perforation in an adolescent. J Pediatr Surg 2012; 47: E11-4.
[http://dx.doi.org/10.1016/j.jpedsurg.2011.12.019]
[7]
Tytgat SH, Zwaveling S, Kramer WL, van der Zee DC. Laparoscopic treatment of gastric and duodenal perforation in children after blunt abdominal trauma. Injury 2012; 43(9): 1442-4.
[http://dx.doi.org/10.1016/j.injury.2010.11.002] [PMID: 21129741]
[8]
Evans PT, Phelps HM, Zhao S, Van Arendonk KJ, et al. Therapeutic laparoscopy for pediatric abdominal trauma. J Pediatr Surg 2019.
[PMID: 31350042]
[9]
Ladd AP, West KW, Rouse TM, et al. Surgical management of duodenal injuries in children. Surgery 2002; 132(4): 748-52.
[http://dx.doi.org/10.1067/msy.2002.127673] [PMID: 12407361]
[10]
Lim KH, Chung BS, Kim JY, Kim SS. Laparoscopic surgery in abdominal trauma: A single center review of a 7-year experience. World J Emerg Surg 2015; 10: 16.
[http://dx.doi.org/10.1186/s13017-015-0007-8] [PMID: 26056529]
[11]
Aiolfi A, Matsushima K, Chang G, et al. Surgical trends in the management of duodenal injury. J Gastrointest Surg 2019; 23(2): 264-9.
[http://dx.doi.org/10.1007/s11605-018-3964-x] [PMID: 30215200]
[12]
Streck CJ, Lobe TE, Pietsch JB, Lovvorn HN III. Laparoscopic repair of traumatic bowel injury in children. J Pediatr Surg 2006; 41(11): 1864-9.
[http://dx.doi.org/10.1016/j.jpedsurg.2006.06.049] [PMID: 17101360]
[13]
Clendenon JN, Meyers RL, Nance ML, Scaife ER. Management of duodenal injuries in children. J Pediatr Surg 2004; 39(6): 964-8.
[http://dx.doi.org/10.1016/j.jpedsurg.2004.02.032] [PMID: 15185235]
[14]
Shilyansky J, Pearl RH, Kreller M, Sena LM, Babyn PS. Diagnosis and management of duodenal injuries in children. J Pediatr Surg 1997; 32(6): 880-6.
[http://dx.doi.org/10.1016/S0022-3468(97)90642-4] [PMID: 9200092]
[15]
Gaines BA, Rutkoski JD, John D, Rutkoski MD. The role of laparoscopy in pediatric trauma. Semin Pediatr Surg 2010; 19(4): 300-3.
[http://dx.doi.org/10.1053/j.sempedsurg.2010.08.001] [PMID: 20889087]

© 2024 Bentham Science Publishers | Privacy Policy