20例闭合性胰腺损伤的漏诊及并发症

漏诊的原因为本病发生率低,损伤后症状和体征不明显,常为合并的严重腹内多脏器损伤所掩盖,致使外科医生对其缺乏警惕,忽略有关病史的询问和检查;手术时甚至只进行腹腔游离性损伤器官的处理,而遗漏对腹膜后深处探查。并讨论了胰腺损伤的并发症和不同类型胰腺损伤的处理。

MISSED DIAGNOSIS AND POSTOPERATIVE COMPLICATIONOF CLOSED PANCREATIC INJURY--A CLINICALANALYSIS OF 20 CASES

The incidence of the closed pancreatic injury is low. The symptoms and signs after this specific type of injury are often unremarkable because of the associated clinical manifestations of other injured visceral organs within the abdominal cavity. Consequently the history taking and clinical examination for the closed pancreatic injury were neglected by those doctors who were unaware of this injury during the operation. They were only satisfied with their management of the easily visible injuries of those visceral organs but often overlooked the possibly injured retroperitoneal pancreas. As a result of this, 13 of 20 cases developed one or more postoperative complications, including subdiaphragmatic abscess, pancreatic fistula and pseudocyst etc.Some discussions of the complications following the pancreatic injury and different types of specific management for the pancreatic injury are recommended.