腹部钝伤导致长段结肠脱落

Journal of medical cases Pub Date : 2024-05-01 Epub Date: 2024-05-02 DOI:10.14740/jmc4205
Aldin Malkoc, Lana Mamoun, Harpreet Gill, Danielle Cremat, Gbemisola Lawal, William Sherman
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引用次数: 0

摘要

腹部钝伤导致中空器官严重受伤的情况极为罕见。结肠脱落损伤是腹部钝伤后最罕见的损伤之一。肠脱落通常发生在急剧减速、速度变化、挤压和机动车碰撞(MVC)之后。尽管病变严重,但肠脱落伤患者可能会出现模糊症状。我们介绍了一例 21 岁男性患者的病例,他患有胰岛素依赖型 1 型糖尿病,在一次高速机动车碰撞中受伤。他四肢二度和三度烧伤,右颈动脉剥离,下颌骨、骨盆和前臂多处骨折。骨盆中还发现了游离液体,因此紧急进行了探查性开腹手术。在手术室里,他被发现有一处盲肠浆膜损伤,涉及周长超过50%,乙状结肠和降结肠脱落损伤达50厘米。手术切除了受伤的部分,并进行了初级吻合。结肠脱落极为罕见,而乙状结肠是记录较多的损伤部位之一。我们的病例为有限的有关这些严重结肠损伤演变治疗的文献做出了贡献。
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Long Segment Colon Degloving From Blunt Abdominal Trauma.

It is extremely rare for blunt abdominal trauma to result in serious injuries to hollow organs. Degloving injuries of the colon are one of the rarest injuries following blunt abdominal trauma. Intestinal degloving is often seen following rapid deceleration, changes in velocity, crushes and motor vehicle collisions (MVCs). Victims with intestinal degloving injuries can experience vague symptoms despite the severity of the lesion. We present the case of a 21-year-old male with insulin-dependent type 1 diabetes who was involved in a high-speed MVC. He sustained second- and third-degree burns to the extremities, right carotid artery dissection, and multiple fractures to the mandible, pelvis and forearm. Free fluid was also noted in the pelvis prompting an emergent exploratory laparotomy. In the operating room, he was found to have a cecal serosal injury involving more than 50% of the circumference and a sigmoid and descending colon degloving injury of 50 cm. The injured segments were resected, and primary anastomoses were created. Degloving of the colon is extremely rare and the sigmoid is one of the more frequently documented locations of injury. Our case contributes to the limited literature available pertaining to the treatment of evolution of these severe colon injuries.

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