Laparoscopic surgery for traumatic perforation of the duodenum by bicycle handlebar injury : A case report Yoshiaki FUJII 1 , Mikinori SATO 1 , Tomohiro KAKO 1 , Hironori SUGIURA 1 , Syuji TAKIGUCHI 2 1Department of Surgery, Gamagori Municipal Hospital 2Department of Gastroenterological Surgery, Nagoya City University Keyword: ハンドル外傷 , 十二指腸穿孔 , 腹腔鏡 pp.310-317
Published Date 2019/7/15
DOI https://doi.org/10.11477/mf.4426200716
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 A 19-year-old woman was delivered to the emergency department with moderate abdominal pain after a fall onto a bicycle's handlebar from a standing position. Physical findings showed tenderness around the navel, but no peritoneal irradiation sign was observed. No abnormalities were found by computed tomography (CT). The patient returned to our hospital the next day due to exacerbation of the abdominal pain. Abdominal CT detected wall thickening of the small intestine, fluid collection and free gas. Laparoscopic surgery was performed 17 hours after the accident. A 2-cm perforation in the duodenum at the posterior wall of the 4th portion was confirmed. Simple sutures of the ruptured bowel were performed laparoscopically. There were no postoperative complications ; the patient started oral ingestion from the 5th postoperative day and was discharged on the 12th postoperative day. For traumatic duodenal perforation, total laparoscopic surgery was useful when the damage was mild.

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