一例车祸后安全带引发的肠系膜损伤和延迟性结肠缺血。

Burak Çelik, Safa Toprak, Mesut Yeşilsoy, İbrahim Halil Özata
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引用次数: 0

摘要

创伤是全球第六大死因,也是年轻患者发病和死亡的主要原因。钝性肠道和肠系膜损伤非常罕见,仅占腹部钝性创伤的 1%-5%,而且发病率和死亡率都很高。在本报告中,我们介绍了一例因肠系膜损伤引起缺血而导致乙状结肠穿孔的患者,该患者在车祸后两天因腹痛入院。一名二十一岁的男子因腹痛和呕吐被送入急诊科,两天前他作为司机遭遇了一场车祸。计算机断层扫描显示腹腔内有游离空气,源于乙状结肠壁穿孔,盆腔内有游离液体。患者立即接受了开腹手术。检查发现乙状结肠系膜破裂,导致缺血和穿孔。此外,回肠末端靠近回盲瓣的肠系膜也有破裂,但没有缺血。他接受了部分乙状结肠和回肠切除术,随后进行了结肠吻合术和双管回肠造口术。住院 20 天后,他健康出院。彻底的临床检查和放射学评估有助于发现外伤患者的内脏损伤。及早发现和修复肠道损伤可以预防严重的并发症。
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A case of seatbelt-induced mesenteric injury and delayed colon ischemia after a car accident.

Trauma is the sixth leading cause of death globally and the leading cause of morbidity and mortality in young patients. Blunt bowel and mesenteric injuries are rare, occuring in only 1-5% of blunt abdominal traumas, and are associated with high morbidity and mortality. In this report, we present a case of a patient with sigmoid colon perforation due to ischemia caused by mesenteric injury, who was admitted to the hospital with abdominal pain two days after a car accident. A twenty-one-year-old man was admitted to the emergency department with abdominal pain and vomiting, having been involved in a car accident as a driver two days prior. Computed tomogra-phy revealed free air in the abdomen, originating from the perforation of the sigmoid colon wall, and free fluid in the pelvic area. The patient underwent immediate laparotomy. Exploration revealed a rupture in the sigmoid mesocolon, causing ischemia and perforation. Additionally, there was a rupture in the mesentery of the terminal ileum close to the ileocecal valve, but without ischemia. Partial sig-moid colon and ileal resections were performed, followed by colocolic anastomosis and double-barrel ileostomy. He was discharged in good health after a 20-day hospital stay. Thorough clinical examination and radiological evaluation can aid in detecting visceral injuries in trauma patients. Early recognition and repair of intestinal damage can prevent severe complications.

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