A CASE OF POSTOPERATIVE PANCREATICODUODENECTOMY AS DAMAGE-CONTROL SURGERY FOR THE DUODENUM DUE TO ABDOMINAL STAB WOUND

Abstract

　　We report a successful case of pancreaticoduodenectomy (PD) after damage-control surgery (DCS) for an abdominal stab wound. A 44-year-old man who stabbed himself in the left upper abdomen with a 20-cm-long kitchen knife was transported to our hospital. He had a Glasgow Coma Scale (GCS) of E3 V4 M5, blood pressure of 60/40 mmHg, and heart rate of 143 beats/min, and underwent emergency surgery. The knife had penetrated through his stomach, duodenum, and transverse mesocolon, and reached the hilum of the right kidney, with pulsatile bleeding. As his vital signs suggested shock, emergency DCS was needed, which included nephrectomy, closure of the gastrointestinal tract, towel packing, and towel clip closure. The following day, PD was performed for the complex duodenal injury. The patient was discharged after 40 postoperative days.