Laparotomy: The conquering of the abdomen and the historical journey of pancreatic and duodenal injuries.

Objective: Describe the barriers to conquering the abdomen by exploratory laparotomy and the historical journey beginning with the original descriptions of pancreatic and duodenal injuries. Background: Unlike cardiac injuries described in the Iliad, pulmonary injuries described by Galen in gladiators and esophageal injuries described in the Edwin Smith Surgical Papyrus; pancreatic and duodenal injuries are relative newcomers to the Annals of Surgical History with their initial descriptions dating back to the 19th Century. Methods: Review of historical literature. Results: Pancreatic and duodenal injuries were first described by Travers in 1827 and Larrey in 1809 respectively. These injuries were difficult to diagnose and also proved to be technically challenging. Military experiences reported from contemporary wars revealed a total of 92 pancreatic and 152 duodenal injuries respectively. Conclusions: Pancreatic and duodenal injuries remain uncommon. It required the undaunted courage of our surgical forefathers, along with their ingenuity to develop the current surgical armamentarium that modern day trauma surgeons utilize to manage these injuries. This historical review truly lends credence to the fact that our progress in the management of these injuries could only occur because we stand on the shoulders of giants. (C) 2016 Lippincott Williams & Wilkins, Inc.

from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/1nyrJr7