Title DUODENALNI ILEUS U DJEČJOJ DOBI
Title (english) Duodenal illeus in children
Author Maja Jakopic
Mentor Harry Nikolić (mentor)
Committee member Nado Bukvić (predsjednik povjerenstva)
Committee member Ana Bosak Veršić (član povjerenstva)
Committee member Srećko Severinski (član povjerenstva)
Granter University of Rijeka Faculty of Medicine (Department of Surgery) Rijeka
Defense date and country 2020-07-17, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Pediatrics
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Surgery
Abstract Duodenalni ileus je patološko stanje u kojem dolazi do prekida prolaska crijevnog sadržaja kroz duodenum. Najčešći uzroci duodenalnog ileusa su duodenalna atrezija i stenoza. Duodenalna atrezija je prirođena anomalija koja podrazumijeva nepostojanje lumena duodenuma, a nastaje zbog poremećaja rekanalizacije između 8. i 12. tjedna gestacije. U oko 30% slučajeva javlja se povezana s Downovim sindromom. Postoji tri tipa duodenalne atrezije. Prvi tip predstavlja intaktna membrana, drugi tip čine dva slijepa atretična kraja povezana fibroznim tračkom, dok kod trećeg tipa taj tračak ne postoji. Stenoza je uzrokovana vanjskim pritiskom na stijenku duodenuma. Najčešći uzrok stenoze je anularni pankreas koji nastaje kada je razvojno ventralni pankreas pričvršćen za stijenku duodenuma i bude vučen oko duodenuma do spajanja s dorzalnim pankreasom. Kad će se simptomi javiti ovisi o stupnju opstrukcije. Prenatalno se u otprilike 50% slučajeva duodenalne atrezije nađe polihidramnij. Najraniji simptom, koji se javlja unutar nekoliko sati nakon rođenja, je povraćanje žučnog sadržaja s obzirom na to da je u 85% slučajeva opstrukcija distalno od ulaza žučnog kanala. Može biti prisutna distenzija abdomena u području epigastrija. Dijagnoza se postavlja na temelju simptoma te potvrđuje rendgenskom dijagnostikom. Na rendgenu se prikazuje tipičan znak dvostrukog mjehura. Prvi mjehur predstavlja želudac, a drugi proksimalni duodenum. Liječenje je kirurško s ciljem uspostave kontinuiteta probavne cijevi. Ovisno u tipu uzroka odabire se metoda operacije. Kod prvog tipa atrezije radi se ekscizija membrane, a kod ostalih se najčešće radi premoštenje mjesta opstrukcije direktnom duodenoduodenostomijom. Danas preživljenje iznosi više od 90%, a ostatak se odnosi na smrtnost zbog anomalija drugih organskih sustava.
Abstract (english) Duodenal ileus is a pathological condition in which the passage of intestinal contents through the duodenum is interrupted. The most common causes of duodenal ileus are duodenal atresia and stenosis. Duodenal atresia is a congenital anomaly that implies the absence of a duodenal lumen and occurs due to a recanalization disorder between the 8th and 12th week of gestation. In about 30% of cases, it occurs associated with Down syndrome. There are three types of duodenal atresia. The first type is an intact membrane, the second type consists of two blind atretic ends connected by a fibrotic band, while in the third type this band does not exist. Stenosis is caused by external pressure on the duodenal wall. The most common cause of stenosis is annular pancreas that occurs when the developmental ventral pancreas is attached to the duodenal wall and drawn around the duodenum until it fuses with dorsal pancreas. When the symptoms will occur depends on the degree of obstruction. Prenatally, in approximately 50% of cases of duodenal atresia, polyhydramnios is found. The earliest symptom, which occurs within hours after birth, is vomiting of the bile stained material, since in 85% of cases the obstruction is distal to the entrance of the bile duct. Abdominal distension in the epigastric region may be present. The diagnosis is made on the basis of symptoms and confirmed by X-ray diagnosis. An X-ray shows the typical double-bubble sign. The first bubble represents the stomach and the second the proximal duodenum. Treatment is surgical with the aim of establishing continuity of the digestive tract. Depending on the type of cause, the method of surgery is chosen. In the first type of atresia, membrane excision is performed, and in the others, the obstruction site is most often bypassed by direct duodenoduodenomy. Today, survival is more than 90%, and the rest refers to mortality due to anomalies of other organ systems.
Keywords
duodenalni ileus
duodenalna atrezija
anularni pankreas
direktna duodenoduodenostomija
Keywords (english)
duodenal ileus
duodenal atresia
anular pancreas
direct duodenoduodenostomy
Language croatian
URN:NBN urn:nbn:hr:184:876189
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2020-11-23 10:42:46