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Phẫu thuật điều trị chấn thương vỡ tá tràng ở trẻ em: Nhân 2 trường hợp

Vỡ tá tràng do chấn thương ở trẻ em là bệnh rất hiếm gặp, việc chẩn đoán và điều trị sớm rất khó khăn do vị trí sau phúc mạc của tá tràng, làm tăng nguy cơ biến chứng và tử vong cho trẻ. Bài viết trình bày báo cáo 2 ca bệnh vỡ tá tràng do chấn thương được phẫu thuật đóng tổn thương tá tràng có kết quả. | Journal of Pediatric Research and Practice Vol. 5 No. 6 2021 53-60 Case Report Primary Repair of Isolated Duodenal Rupture in Children Two Cases Report To Manh Tuan Tran Xuan Nam Tran Hung Nguyen Van Sang 1 Vietnam National Children s Hospital 18 879 La Thanh Dong Da Hanoi Vietnam Received 15 September 2021 Revised 22 September October 2021 01 October 2021 Abstract Objective Traumatic duodenal rupture in children is a very rare disease difficult to diagnose and treat due to the retroperitoneal location of the duodenum increasing the risk of mortality and complications for the patient. We report 2 cases of children with isolated duodenal rupture due to trauma who underwent primary repair without diversion with good results. Case 1 A 3-year-old female who presented at local hospital with acute abdominal pain due to isolated duodenal rupture following trauma of the handle bar of motocycle on the upper abdominal region. An exploratory laparotomy by the right paramedian incision was perfomed to close duodenal rupture at 23 hours after the impact. On the 3rd day after surgery the child showed signs of severe sepsis then was transferred to our hospital. She was on ECMO and hemodialysis. Day 11th after the injury there was bile leaking through the incision. The child underwent the second operation. A rupture of D3-4 portion of the duodenum revealed. No other injuries were found. We performed single layer duodejejunostomy. Complete oral feeding commenced 25 days postoperatively and the patient was released from hospital 39 days after surgery. Case 2 A 2.5-year-old female was admitted to the hospital due to abdominal pain following a motocycle accident. On admission the child was alert the temperature was 38 degrees abdominal pain. Computed tomography of the abdomen was done which revealed free fluid in the peritoneal cavity and localized free air in retroperitoneum around third part of duodenum which was communicating with the lumen. She was resuscitated for shock and had