3. History
ď Male child aged 6 years.
ď Presented with history of abdominal
pain and repeated vomiting, gastric
in nature at first then became bilious
that started 48 hours ago.
ď With further and thorough history
taking, the parents mentioned a
history of blunt abdominal trauma.
4. History
ď The parents sought medical advice,
ultrasound was requested and
showed biliary sludge with no other
abnormalities.
ď So, Diagnosis of acute cholecystitis
was considered.
5. History
ď The patient didnât improve on medical
treatment.
ď Ultrasound was repeated, showing an
epigastric mass.
6. Examination & investigations
When the patient presented to us:
ďExamination showed diffuse
abdominal tenderness mainly epigastric.
No mass was felt clinically.
ďUltrasound was repeated and showed
query duodenal hematoma, CTabdomen
and pelvis followed U/S confirming the
diagnosis.
14. HomeMessage
ďDuodenal injuriesareuncommon and both difficult to
diagnoseand repair.
ďDiagnosisismoredifficult in blunt injuriesand requires
high index of suspicion.
ďNo specific diagnostic test found to be accurate all of the
time.
ďIntra-op findingsthat requireexploration:
ďź Crepitusalong theduodenal sweep
ďź Bilestaining of paraduodenal or adjacent tissues
ďź Right-sided retroperitoneal or periduodenal hematoma
Hinweis der Redaktion
بس٠اŮŮ٠اŮŘąŘ٠٠اŮŘąŘŮ٠اŮŘłŮا٠ؚŮŮŮŮ
Todayâs discussion about duodenal trauma starts with a case presentation
This was a âŚ
Falling off a cargo
In the parentâs own words
rather than penetrating injuries that usually necessitates urgent exploration