Proximal jejunal stoma as ultima ratio in case of traumatic distal duodenal perforation facilitating successful EndoVAC\(^{®}\) treatment: a case report
Zitieren Sie bitte immer diese URN: urn:nbn:de:bvb:20-opus-159292
- Introduction:
During damage control surgery for blunt abdominal traumata simultaneous duodenal perforations can be missed making secondary sufficient surgical treatment challenging. Endoluminal vacuum (EndoVAC™) therapy has been shown to be a revolutionary option but has anatomical and technical limits.
Presentation of the case:
A 59-year old man with hemorrhagic shock due to rupture of the mesenteric root after blunt abdominal trauma received damage control treatment. Within a scheduled second-look, perforation of the posterior duodenalIntroduction:
During damage control surgery for blunt abdominal traumata simultaneous duodenal perforations can be missed making secondary sufficient surgical treatment challenging. Endoluminal vacuum (EndoVAC™) therapy has been shown to be a revolutionary option but has anatomical and technical limits.
Presentation of the case:
A 59-year old man with hemorrhagic shock due to rupture of the mesenteric root after blunt abdominal trauma received damage control treatment. Within a scheduled second-look, perforation of the posterior duodenal wall was identified. Due to local and systemic conditions, further surgical treatment was limited. Decision for endoscopic treatment was made but proved to be difficult due to the distal location. Finally, double-barreled jejunal stoma was created for transstomal EndoVAC™ treatment. Complete leakage healing was achieved and jejunostomy reversal followed subsequently.
Discussion:
During damage control surgery simultaneous bowel injuries can be missed leading to life-threatening complications with limited surgical options. EndoVAC™ treatment is an option for gastrointestinal perforations but has anatomical limitations that can be sufficiently shifted by a transstomal approach for intestinal leakage.
Conclusion:
In trauma related laparotomy complete mobilization of the duodenum is crucial. As ultima ratio, transstomal EndoVAC™ is a safe and feasible option and can be considered for similar cases.…
| Autor(en): | M. Kelm, F. Seyfried, S. Reimer, K. Krajinovic, A. D. Miras, C. Jurowich, C. T. Germer, M. Brand |
|---|---|
| URN: | urn:nbn:de:bvb:20-opus-159292 |
| Dokumentart: | Artikel / Aufsatz in einer Zeitschrift |
| Institute der Universität: | Medizinische Fakultät / Klinik und Poliklinik für Allgemein-, Viszeral-, Gefäß- und Kinderchirurgie (Chirurgische Klinik I) |
| Medizinische Fakultät / Medizinische Klinik und Poliklinik II | |
| Sprache der Veröffentlichung: | Englisch |
| Titel des übergeordneten Werkes / der Zeitschrift (Englisch): | International Journal of Surgery Case Reports |
| Erscheinungsjahr: | 2017 |
| Band / Jahrgang: | 41 |
| Seitenangabe: | 401–403 |
| Originalveröffentlichung / Quelle: | International Journal of Surgery Case Reports 41 (2017) 401–403. DOI: 10.1016/j.ijscr.2017.11.022 |
| DOI: | https://doi.org/10.1016/j.ijscr.2017.11.022 |
| Allgemeine fachliche Zuordnung (DDC-Klassifikation): | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 617 Chirurgie und verwandte medizinische Fachrichtungen |
| Freie Schlagwort(e): | EndoVAC and small bowel; duodenal perforation; duodenal trauma; transstomal endoluminal vacuum therapy |
| Datum der Freischaltung: | 28.03.2018 |
| Sammlungen: | Open-Access-Publikationsfonds / Förderzeitraum 2017 |
| Lizenz (Deutsch): |  CC BY-NC-ND: Creative-Commons-Lizenz: Namensnennung, Nicht kommerziell, Keine Bearbeitungen 4.0 International |