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Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
Published on: February 28, 2025
[Duodenum perforations in children: case series]
Şenol Emre1, Emrah Aydın2, Rahşan Özcan2
1Department of Pediatric Surgery, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul, Turkey. senolemre@hotmail.com.
Insights
Duodenal perforation is rare in children, often caused by ulcers or trauma. Primary repair, with or without omentoplasty, is a safe and effective surgical treatment for pediatric duodenal perforation.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
Background:
- Duodenal perforation is a rare but serious condition in pediatric patients.
- Prompt diagnosis and surgical intervention are crucial for favorable outcomes.
Purpose of the Study:
- To analyze the clinical characteristics, surgical management, and outcomes of pediatric patients with duodenal perforation.
- To evaluate the efficacy of primary repair (duodenoraphy ± omentoplasty) as a surgical treatment.
Main Methods:
- Retrospective analysis of 14 pediatric patients admitted with duodenal perforation between 1990 and 2014.
- Review of patient demographics, etiology, time to presentation, surgical procedures, and follow-up data.
Main Results:
- The mean age of patients was 6.2 years; common causes included duodenal ulcers (10 cases), trauma (3 cases), and surgical complications (1 case).
- Primary repair with omentoplasty was performed in 9 cases, with 12 patients experiencing good outcomes post-operatively.
- Two patients died, highlighting the severity of the condition.
Conclusions:
- Pediatric duodenal perforation, though uncommon, requires prompt recognition and management by pediatric surgeons.
- Primary repair, particularly duodenoraphy with omentoplasty, demonstrates safety and reliability in treating this condition.
Abstract:
To analyse patients those admitted to our clinic due to perforation in duodenum. Fourteen patients those have been admitted to our center with perforation in duodenum between 1990 - 2014 analysed retrospectively. Ten patients (8M, 6F) those have been admitted to our clinic between 1990 - 2014 have a mean age of 6.2 years (25 days - 16 years). Two of cases admitted directly to our clinic and the rest referred from another hospitals. Mean time for appliance to our clinic was 3.2 days (1day - 1 week). Ulcer in duodenum was the cause of perforation in 10 cases while in 3 the cause was trauma and in 1 case was surgical complication of infantly persistant hyperinsulinism (IPHH). The case with hyperbilluribinemia after near total pancreatectomy due to IPHH had been explored and perforation in deuedenum diagnosed. Resection in first two parts of duodenum and pylor, choledochojejunostomy, gastrojejunostomy and jejunojejunostomy was performed. Primary repair was performed in the remaining patients. In one case with primary repair gastrostomy was performed, while in 9 cases omentoplasty were performed. In the follow-up 12 cases has no problems and doing well. Two patients died. Perforation in duedenum is a rare entity that pediatric surgeons should encounter and keep in mind. Primary repair (duodenoraphy ± omentoplasty) is safe and reliable surgical treatment modality.
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