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Duodenal trauma


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Case presentation of a rare case pf pediatric duodenal trauma

Published in: Health & Medicine
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Duodenal trauma

  1. 1. Duodenal Trauma in Pediatrics Presented by: Mahmoud Motawea Assistant Lecturerof Pediatric Surgery
  2. 2. History  Male child aged 6 years.  Presented with history of abdominal pain and repeated vomiting, gastric in nature at first then became bilious that started 48 hours ago.  With further and thorough history taking, the parents mentioned a history of blunt abdominal trauma.
  3. 3. History  The parents sought medical advice, ultrasound was requested and showed biliary sludge with no other abnormalities.  So, Diagnosis of acute cholecystitis was considered.
  4. 4. History  The patient didn’t improve on medical treatment.  Ultrasound was repeated, showing an epigastric mass.
  5. 5. Examination & investigations When the patient presented to us: Examination showed diffuse abdominal tenderness mainly epigastric. No mass was felt clinically. Ultrasound was repeated and showed query duodenal hematoma, CTabdomen and pelvis followed U/S confirming the diagnosis.
  6. 6. Examination & investigations
  7. 7. Examination & investigations
  8. 8. Examination & investigations
  9. 9. Examination & investigations
  10. 10. Surgical intervention
  11. 11. Surgical intervention
  12. 12. Surgical intervention
  13. 13. HomeMessage Duodenal injuriesareuncommon and both difficult to diagnoseand repair. Diagnosisismoredifficult in blunt injuriesand requires high index of suspicion. No specific diagnostic test found to be accurate all of the time. Intra-op findingsthat requireexploration:  Crepitusalong theduodenal sweep  Bilestaining of paraduodenal or adjacent tissues  Right-sided retroperitoneal or periduodenal hematoma