Ho L C, El Shafei H, Barr J, Al Kari B, Aly E H
University of Aberdeen, UK.
Ann R Coll Surg Engl. 2012 Sep;94(6):e201-3. doi: 10.1308/003588412X13373405385016.
Impalement rectal injuries with intraperitoneal organ injuries are rare. It is even rarer for such injuries to result in pelvic, abdominal and thoracic internal injuries. We present the case of a 39-year-old man who was admitted after an assault where a broken broomstick was inserted forcibly into his rectum. Surgery revealed penetration through the rectum, dome of the bladder, mesentery, liver and right lung. The patient survived following management by a multispecialty surgical team. Our literature review identified four similar cases with one fatality only. Prognosis seems to be good in these types of injuries provided there is an early presentation, the penetrating object is left in situ before the operation and, most importantly, there is an organised team approach to deal with the various injuries.
直肠贯通伤合并腹腔内器官损伤较为罕见。此类损伤导致盆腔、腹部和胸部内部损伤的情况更为罕见。我们报告一例39岁男性患者，他在一次袭击后入院，一根折断的扫帚柄被强行插入其直肠。手术发现直肠、膀胱穹窿、肠系膜、肝脏和右肺均有穿透伤。该患者经多专科手术团队治疗后存活。我们的文献回顾发现了4例类似病例，仅1例死亡。对于这类损伤，若能早期就诊、手术前将穿透物体留在原位，且最重要的是有一个有组织的团队方法来处理各种损伤，预后似乎良好。
