Transection of the stomach after blunt injury in the pediatric population

Rupture gastrique sur traumatisme fermé de l’abdomen: à propos de 2 cas et revue de la littérature

“…Our two patients had full stomach and were involved in traumatism with high velocity impact. One had a lesion in the anterior wall, which is the most common site of gastric lesion, followed by the greater curvatum, the lesser curvature and the posterior wall [4,14], while the other patient had a complete gastric rupture at the pyloro-duodenal junction, an even rarer type of gastric lesion which is not specially included in the accepted stomach injury classification as postulated by Begossi et al [15,16]. Gastric rupture is well known for its association with solid organs injuries like spleen, pancreas, liver.…”

“…In our patients, presence on CT of massive peritoneal free air and fluid led us to perform emergent exploratory laparotomy. Emergent exploratory laparotomy is required for blunt gastric injury [15]. Through a midline incision, the control of hemorrhage is the first priority before control of gastric spill [6].…”

“…Aboobakar et al have suggested a management of blunt gastric injury according to the grade of injury [7]. A full thickness blunt gastric rupture is repaired by primary two-layer technic with absorbable suture after a proper debridement and refreshing of edges [7,13,15,21]. In case of complete gastric transection direct repair by end-to-end anastomosis has been practiced by most authors [15,22].…”

“…A full thickness blunt gastric rupture is repaired by primary two-layer technic with absorbable suture after a proper debridement and refreshing of edges [7,13,15,21]. In case of complete gastric transection direct repair by end-to-end anastomosis has been practiced by most authors [15,22]. In situations in which there is an associated duodenal injury requiring bypass, a gastrojejunostomy is appropriate [15].…”

“…In case of complete gastric transection direct repair by end-to-end anastomosis has been practiced by most authors [15,22]. In situations in which there is an associated duodenal injury requiring bypass, a gastrojejunostomy is appropriate [15]. In case n°2 we did first a splenectomy to control hemorrhage before a one-layer running absorbable suture as in elective surgery with good outcome, while in case n°1, a perihepatic packing was done before a Roux-en-Y gastrojejunostomy as the rupture was located at pyloro-duodenal junction and the surgery done over 24 hours after the traumatism.…”