Addeo Pietro, Calabrese Daniela Paola
Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg - Université de Strasbourg, France.
Int J Surg Case Rep. 2011;2(8):316-8. doi: 10.1016/j.ijscr.2011.10.005. Epub 2011 Oct 19.
Small bowel injuries after blunt abdominal trauma represent both a diagnostic and a therapeutic challenge. Early diagnosis and prompt treatment are necessary in order to avoid a dangerous diagnostic delay. Laparoscopy can represent a diagnostic and therapeutic tool in patients with uncertain clinical symptoms.
We report the case of a 25-year-old man, haemodynamically stable, admitted for acute abdominal pain a few hours after a physical assault. Giving the persistence of the abdominal pain and the presence of free fluids at the computed tomography examination, an exploratory laparoscopy was performed.
At the laparoscopic exploration, an isolated small bowel perforation was found, 60 cm distal from the ligament of Treitz. The injury was repaired by laparoscopic suturing and the patient was discharged home at postoperative day 3 after an uneventful postoperative course.
Laparoscopy represents a valuable tool for patients with small bowel blunt injuries allowing a timely diagnosis and a prompt treatment.
钝性腹部创伤后的小肠损伤既是诊断上的挑战，也是治疗上的挑战。为避免危险的诊断延误，早期诊断和及时治疗很有必要。对于临床症状不明确的患者，腹腔镜检查可作为一种诊断和治疗手段。
我们报告一例25岁男性患者，血流动力学稳定，在遭受身体攻击数小时后因急性腹痛入院。鉴于腹痛持续存在且计算机断层扫描检查发现有游离液体，遂进行了探查性腹腔镜检查。
在腹腔镜探查中，发现距屈氏韧带60厘米处有一处孤立的小肠穿孔。通过腹腔镜缝合修复了损伤，术后过程平稳，患者于术后第3天出院回家。
对于小肠钝性损伤患者，腹腔镜检查是一种有价值的手段，可实现及时诊断和迅速治疗。
