闭合性腹膜后十二指肠破裂的诊断与治疗

目的　提高闭合性腹膜后十二指肠破裂的早期诊断与治疗水平。方法　回顾性总结我院 1991～ 2 0 0 2年经手术证实闭合性腹膜后十二指肠破裂 12例早期诊断与治疗经验。结果　入院后 1h确诊 7例 ,2h确诊 4例 ,3h确诊 1例。经口服泛影葡胺十二指肠造影诊断 7例 ,结合充气造影诊断 4例 ,纤维十二指肠镜检查确诊 1例 ,手术后并发症发生率为 2 5 % ( 3 / 12 ) ,病死率为8% ( 1/ 12 )。结论　掌握闭合性腹膜后十二指肠破裂的临床特点 ,早期诊断 ,及时手术是提高治愈率的关键。

Diagnosis and treatment of closure peritoneal duodenal rupture

Objective To improve the early diagnosis and treatment of closure peritoneal duodenal rupture.Methods The experience of early diagnosis and treatment in 12 cases of closure peritoneal duodenal rupture confirmed surgically in our hospital during 1991 to 2002 was retrospectively analyzed.Results Among the 12 patients,7 were definitely diagnosed in 1 h after admission,4 in 2 h and 1 in 3 h.Seven cases of closure peritoneal duodenal rupture were diagnosed by duodenal radiography,4 cases by aerating radiography and one case by fabric duodenoscopy.The incidence of post-operative complication was 25%(3/12) and morality 8% (1/12).Conclusion Understanding the clinic feature of closure peritoneal duodenal rupture,early diagnosis and prompt operation are the key points to the higher curative rate.