tailieunhanh - báo cáo khoa học: " Peritonitis secondary to traumatic duodenal laceration in the presence of a large pancreatic pseudocyst: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài:Peritonitis secondary to traumatic duodenal laceration in the presence of a large pancreatic pseudocyst: a case report | Tuboku-Metzger et al. Journal of Medical Case Reports 2011 5 528 http content 5 1 528 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Peritonitis secondary to traumatic duodenal laceration in the presence of a large pancreatic pseudocyst a case report Vanessa RE Tuboku-Metzger Marlon M Seenath and Lam Chin Tan Abstract Introduction A pancreatic pseudocyst is a common sequela of severe acute pancreatitis. Commonly it presents with abdominal pain and a mass in the epigastrium several weeks after the acute episode and can be managed conservatively endoscopically or surgically. We report a patient with a pancreatic pseudocyst awaiting endoscopic therapy who developed a life-threatening complication following a rather innocuous trauma to the abdomen. Case presentation A 23-year-old Asian male student presented as an emergency with an acute abdomen a week after a minor trauma to his upper abdomen. The injury occurred when he was innocently punched in the abdomen by a friend. He experienced only moderate discomfort briefly at the time. His past medical history included coeliac disease and an admission four months previously with severe acute pancreatitis. He was hospitalized for 15 days his pancreatitis was thought to be due to alcohol binge drinking on weekends. Ultrasound scanning showed no evidence of gallstone disease. Five days after the trauma he became anorexic lethargic and feverish and started vomiting bilious content. Seven days post-trauma he presented to our emergency department with severe abdominal pain. An emergency laparotomy was performed where a transverse linear duodenal laceration was found at the junction of the first and second part of his duodenum with generalized peritonitis. His stomach and duodenum were stretched over a large pancreatic pseudocyst posterior to his stomach. It was postulated that an incomplete duodenal injury possibly a serosal tear occurred following the initial minor trauma which was followed