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异物引起的阻塞性直肠壁内血肿。

Obstructive rectal intramural hematoma caused by a foreign body.

作者信息

Battal Bilal, Kocaoglu Murat, Ors Fatih, Akgun Veysel, Tasar Mustafa

机构信息

Department of Radiology, Gulhane Military Medical School, 06018, Etlik, Ankara, Turkey.

出版信息

Emerg Radiol. 2009 Jan;16(1):75-7. doi: 10.1007/s10140-008-0700-y. Epub 2008 Mar 12.

Abstract

Intramural hematoma of the alimentary tract is a rare condition, which usually results from blunt injury. It can spontaneously occur in patients with coagulopathy or on anticoagulants. Although it may be seen anywhere in the alimentary tract, duodenum is the most common site of the intestinal intramural hematomas. Intramural hematoma caused by a foreign body is rarely seen. Patients with intramural hematoma are usually encountered with obstructive symptoms after an isolated injury. Intramural hematomas are often self-limited at the site of occurrence and can be managed conservatively. They rarely cause progressive obstruction and need surgical drainage. In this article, we report a 51-year-old male patient with foreign body used for masturbation causing rectal intramural hematoma and perforation at the rectosigmoid junction. Because of the intestinal perforation, the patient was managed surgically. In the diagnosis of intramural hematoma of the alimentary tract, beside the clinical history and physical examination, the findings at imaging modalities such as conventional radiography, ultrasonography, and computed tomography are often useful. Patients with rectal intramural hematoma usually do not give diagnostic clues to the physicians in the clinical history. Therefore, radiologists must be familiar with the imaging findings. In this article, we aimed to present a patient with rectal intramural hematoma caused by foreign body and obliterating the rectal lumen.

摘要

消化道壁内血肿是一种罕见病症,通常由钝性损伤引起。它可自发发生于患有凝血病或正在使用抗凝剂的患者。尽管消化道壁内血肿可见于消化道的任何部位,但十二指肠是肠道壁内血肿最常见的部位。由异物引起的壁内血肿很少见。壁内血肿患者在遭受孤立性损伤后通常会出现梗阻症状。壁内血肿在发生部位往往具有自限性,可采用保守治疗。它们很少导致进行性梗阻,需要手术引流。在本文中,我们报告了一名51岁男性患者,其因用于自慰的异物导致直肠乙状结肠交界处直肠壁内血肿并穿孔。由于肠道穿孔,该患者接受了手术治疗。在消化道壁内血肿的诊断中,除了临床病史和体格检查外,传统X线摄影、超声检查和计算机断层扫描等影像学检查结果通常很有用。直肠壁内血肿患者在临床病史中通常不会给医生提供诊断线索。因此,放射科医生必须熟悉影像学表现。在本文中,我们旨在介绍一名因异物导致直肠壁内血肿并使直肠管腔闭塞的患者。

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