Ring A, Stein E, Stern J
St. Josefs Hospital Dortmund-Süd, Abteilung für Allgemein-, Viszeral- und Unfallchirurgie, Darmzentrum Ruhr, Dortmund, Deutschland.
Zentralbl Chir. 2010 Jun;135(3):267-9. doi: 10.1055/s-0029-1224513. Epub 2009 Dec 11.
Since the 1980s the abuse of cocaine has been -associated with gastroduodenal perforations in the United States. Here, we report the case of a 28-year-old man who came to our hospital with severe abdominal pain after smoking cocaine. Physical examination revealed generalised abdominal guarding. His X-ray did not show any free intraperitoneal air. However, there was a slightly elevated white blood cell count. Upon laparoscopic exploration of the abdomen, the -patient was found to have a generalised peritonitis secondary to a perforation of the prepyloric anterior wall. The operative procedure consisted of ulcer excision and primary closure with a pyloroplasty as well as an extensive abdominal irrigation after laparotomy.
自20世纪80年代以来,在美国,可卡因滥用一直与胃十二指肠穿孔有关。在此,我们报告一例28岁男性病例,该患者吸食可卡因后因严重腹痛前来我院就诊。体格检查发现全腹压痛。其X线检查未显示腹腔内有游离气体。然而,白细胞计数略有升高。经腹腔镜探查腹部,发现患者因幽门前壁穿孔继发弥漫性腹膜炎。手术步骤包括溃疡切除、一期缝合并做幽门成形术,以及剖腹术后进行广泛的腹腔冲洗。