Rankin Alan, Awwad Amir, Harding Brendan
Erne Hospital, Cornagrade Road, Enniskillen, Co. Fermanagh, BT74 6AY, UK.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.12.2008.1406. Epub 2009 Jul 14.
A case is presented of a 24-year-old man who sustained a forceful blow to the right side of the abdomen during a tackle while playing rugby union. The patient was thought to be "winded" and could not play on. He sought medical attention several hours later at the local hospital where initial evaluation revealed mild right iliac fossa tenderness with no signs of peritonism and clinical parameters showed haemodynamic stability. Subsequent ultrasound and CT evaluation revealed a large haematoma involving the caecum and ascending colon. Emergency right haemicolectomy with primary anastomosis was performed to remove the large haematoma within the intact colonic wall. He was observed in the high dependency unit and was discharged after 7 days following an uneventful postoperative course. He continues to make significant progress some 3 months later and a full return to contact sport is being proposed within 9-12 months.
本文报告一例24岁男性病例,该患者在参加英式橄榄球联合会比赛时被擒抱,腹部右侧受到强力撞击。患者起初被认为是“岔气”,无法继续比赛。数小时后,他前往当地医院就医,初步评估显示右下腹轻度压痛,无腹膜炎体征,临床指标显示血流动力学稳定。随后的超声和CT检查发现,盲肠和升结肠有一个巨大血肿。遂行急诊右半结肠切除术并一期吻合,以清除完整结肠壁内的巨大血肿。患者在高依赖病房接受观察,术后过程平稳,7天后出院。约3个月后,他继续取得显著进展,预计9至12个月内可完全恢复接触性运动。