PMC7358249_01
Duodenal transection in a 3-year-old boy caused by abuse. A, The patient had several old bruises on the cheeks and back. B, Blood gas analysis and blood chemistry examination in a 3-year-old boy with duodenal transection showed metabolic acidosis and high value of inflammatory response, respectively. Alb, albumin; ALP, alkaline phosphatase; ALT, alanine aminotransferase; AMY, amylase; AST, aspartate aminotransferase; BE, base excess; BUN, blood urea nitrogen; Cre, creatinine; ChE, cholinesterase; CK, creatine kinase; CRP, C-reactive protein; D-Bil, direct bilirubin; FDP, fibrin degradation products; Fib, fibrinogen; Hb, hemoglobin; Lac, lactate; LDH, lactate dehydrogenase; PLT, platelets; PT, prothrombin time; PT-INR, prothrombin time - international normalized ratio; RBC, red blood cells; T-Bil, total bilirubin; TP, total protein; WBC, white blood cells. C, Abdominal computed tomography showed rupture of the duodenal wall structure at the horizontal part, and free air in the retroperitoneal cavity and abdominal cavity.
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Physical examination showed several old bruises on the patient's cheeks and back (Fig. 1A). Blood gas analysis and blood chemistry tests showed metabolic acidosis and high value of inflammatory response (Fig. 1B). The patient was diagnosed with duodenal perforation (Fig. 1C).
Duodenal transection in a 3-year-old boy caused by abuse. A, The transverse mesocolon was damaged, and the duodenum was completely transected at the horizontal part. B, The duodenal anal side stump was closed, and duodenojejunostomy was carried out in end-to-side anastomosis fashion with the Albert-Lambert method.
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The transverse mesocolon was damaged, and there was complete transection at the horizontal part of the duodenum (Fig. 2A). The duodenal anal-side stump was closed, and end-to-side anastomosis by the Albert-Lambert method was carried out between the duodenal oral side and the upper jejunum (Fig. 2B).