List Archives

Mon Jul 7 10:29:12 BST 2008

Mathias

NGT to decompress the stomach and D1 - contrast to ensure that there is
no leak from the bowel (yes, I know it is not 100% reliable, but its all
you've got if you want to be conservative) and once that is proven -
wait - if this is only a intramural haematoma it should resolve after
about a week. TPN him in the meanwhile.

Time heals these wounds

Tim
Dr Timothy C Hardcastle
M.B., Ch.B. (Stell); M. Med (Chir) (Stell); FCS (SA)
Principal Surgeon-Lecturer / Sub-specialist: Trauma and Critical Care
Deputy director: Trauma Unit and Trauma ICU
Inkosi Albert Luthuli Central Hospital / UKZN
800 Bellair Road
Mayville, Durban

Postal: PostNet Suite 27
Private Bag X05
Malvern, 4055
KwaZulu Natal

timothyhar at ialch.co.za 

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Mathias Kalkum
Sent: 07 July 2008 10:11
To: Trauma Org
Subject: blunt duodenal trauma

Learned experts,

today I saw a 17 y/o male who suffered blunt abdominal trauma 6 days 
ago. On day five he went to another hospital due to mild abdominal pain 
and nausea, from where he was send to us because "our US is not
working".

On admission, mild tenderness mid right abdomen, nausea, bilirubin 
slightly elevated (3.5), no free fluid. On ward for observation.

When I met him first time this morning he still had mild tenderness 
right mid abdomen and a palpable mass. Sono showed large retroperitoneal

formation in the upper to mid right abdomen, cava obstruted, mild 
congestion of right urether, massiv fluid in stomach and first part of 
duodenum. CT showed large, at least partially intramural haematoma of 
the duodenum *behind* the papilla. Still haemodynamically stable and 
feeling quite well.

What now?

Mathias
--
trauma-list : TRAUMA.ORG
To change your settings or unsubscribe visit:
http://www.trauma.org/index.php?/community/

List Archives

For your convenience, find the Trauma List Archive Below

blunt duodenal trauma