Xeropotamos N S, Nousias V E, Ioannou H V, Kappas A M
Department of Surgery, Faculty of Medicine, Ioannina University, Greece.
Eur J Surg. 2001 Feb;167(2):106-9. doi: 10.1080/110241501750070547.
To present our experience of mesenteric injuries after blunt abdominal trauma.
Retrospective study.
University hospital, Greece.
31 patients with mesenteric injuries out of 333 who required operations for blunt abdominal trauma between March 1978 and March 1998. 21 were diagnosed within 6 hours (median 160 min, early group) and in 10 the diagnosis was delayed (median 21 hours, range 15 hours-7 days, delayed group).
Emergency laparotomy.
Mortality, morbidity, and hospital stay.
There were no deaths. The diagnosis was confirmed by diagnostic peritoneal lavage in 17/21 patients in the early group whereas 7/10 in the delayed group were diagnosed by clinical examination alone. Most of the injuries (n = 23) were caused by road traffic accidents. 30 patients had injured the small bowel mesentery and 4 the large bowel mesentery. 25 of the 31 patients had associated injuries. There were no complications in the early group, compared with 6 wound infections and 1 case of small bowel obstruction in the delayed group (p < 0.0001). Median hospital stay in the early group was 11 days (range 3-24) compared with 23 days (range 10-61) in the delayed group (p = 0.004).
Because delay in diagnosis is significantly associated with morbidity and duration of hospital stay we recommend that all patients admitted with blunt abdominal trauma should have a diagnostic peritoneal lavage as soon as possible
介绍我们在钝性腹部创伤后肠系膜损伤方面的经验。
回顾性研究。
希腊的大学医院。
1978年3月至1998年3月期间，333例因钝性腹部创伤需要手术治疗的患者中有31例发生肠系膜损伤。21例在6小时内确诊（中位时间160分钟，早期组），10例诊断延迟（中位时间21小时，范围15小时至7天，延迟组）。
急诊剖腹手术。
死亡率、发病率和住院时间。
无死亡病例。早期组21例患者中有17例通过诊断性腹腔灌洗确诊，而延迟组10例中仅7例通过临床检查确诊。大多数损伤（n = 23）由道路交通事故引起。30例患者小肠系膜受伤，4例大肠系膜受伤。31例患者中有25例伴有其他损伤。早期组无并发症，延迟组有6例伤口感染和1例小肠梗阻（p < 0.0001）。早期组中位住院时间为11天（范围3 - 24天），延迟组为23天（范围10 - 61天）（p = 0.004）。
由于诊断延迟与发病率和住院时间显著相关，我们建议所有因钝性腹部创伤入院的患者应尽快进行诊断性腹腔灌洗。
