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PubMed · 2190332

Duodenal injuries.

J A Weigelt
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Abstract

The lethal potential of duodenal trauma relates to the severity of the defect, associated injuries, expedient diagnosis, and adequacy of repair. A high index of suspicion must be used in patients sustaining blunt abdominal trauma. An aggressive approach to penetrating abdominal trauma will detect the majority of duodenal injuries in a timely fashion. The unique anatomic and physiologic characteristics of the duodenum demand careful selection of the operative repair to fit the injury. A classification scheme is reviewed that should help the surgeon select the appropriate procedure from a multitude of choices. Standard postoperative care is required. Adherence to these principles should result in acceptable morbidity and mortality in patients with duodenal injuries.

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J A Weigelt. 1990. Duodenal injuries.. https://doi.org/10.1016/s0039-6109(16)45128-5

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Maturation of antroduodenal motor activity in preterm and term infants.

Previous studies have shown that duodenal motility patterns differ in preterm and term infants, but antral motor activities were not compared. Using a validated, low-compliance, continuous-perfusion, neonatal manometric system, antral and duodenal motility was studied in 19 preterm and nine term infants. Antral motility consisted of isolated single contractions and clustered phasic contractions in term and preterm infants. There were no differences in the occurrence or amplitude of antral activity between the two groups of infants. Thus, there was no change of antral motor activity with advancing gestational age. As has been shown in other previous studies, however, intestinal motor characteristics were more immature in preterm than term infants; clustered phasic contractions occurred more frequently (P less than 0.02) and were of shorter duration (P less than 0.02) and lower amplitude (P less than 0.005). Duodenal clusters were significantly less common, while their amplitudes were significantly increased with increasing gestational age. The proportion of antral clusters that were temporally associated with duodenal activity was significantly lower in preterm infants than in term infants (P less than 0.001). Moreover, the degree of association of antral and duodenal activity increased significantly with gestational age (r = 0.5, P = 0.006). These data show that fasting antral motor activity per se is comparable in preterm and term infants; they also suggest that the temporal association of antral and duodenal activity develops in association with progressive changes in duodenal motor activity in the preterm infant.

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