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方向盘创伤后孤立性小肠系膜损伤。

Isolated small bowel mesentery injury after steering wheel trauma.

作者信息

Wani Imtiaz, Bhat Rayees A, Wani Shayiq, Khan Nawab, Wani Rauf A, Parray Fazal Q

机构信息

Department of surgery SKIMS, Kashmir, India.

Department of surgery SMHS Hospital, Kashmir, India.

出版信息

Trauma Mon. 2012 Summer;17(2):279-81. doi: 10.5812/traumamon.4960. Epub 2012 Jul 31.

DOI:10.5812/traumamon.4960
PMID:24350106
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3860640/
Abstract

BACKGROUND

Isolated small gut mesentery injury after blunt abdominal trauma from the steering wheel in road traffic accidents is rare. These are always challenging to diagnose and pose a diagnostic dilemma.

OBJECTIVES

To study the pattern of small gut mesenteric injury by steering wheel blunt abdominal trauma in road traffic accidents in patients who had laparotomy.

PATIENTS AND METHODS

A 10-year retrospective study was done to study isolated small gut mesentery injury.

RESULTS

All patients who had isolated mesenteric small gut injury were males. Jejunal mesentery was involved in 13 whereas 4 had ileal mesentery injury. Tear were longitudinal or transverse.

CONCLUSIONS

Isolated small mesentery injury after blunt abdominal trauma from the steering wheel in road traffic accidents is rare. Tears are either longitudinal or transverse. Suture repair is to be done. Delay in reaching hospital or reaching the diagnosis could lead to morbidity and mortality. Isolated mesenteric injury should be considered in any patient with blunt abdominal trauma from steering wheel injury with no evidence of any solid organ injury in unstable patients.

摘要

背景

道路交通事故中方向盘钝性腹部创伤后孤立性小肠系膜损伤罕见。这些损伤的诊断总是具有挑战性,会造成诊断困境。

目的

研究在接受剖腹手术的患者中,道路交通事故中方向盘钝性腹部创伤所致小肠系膜损伤的模式。

患者与方法

进行了一项为期10年的回顾性研究,以研究孤立性小肠系膜损伤。

结果

所有发生孤立性小肠系膜损伤的患者均为男性。13例累及空肠系膜,4例为回肠系膜损伤。撕裂为纵向或横向。

结论

道路交通事故中方向盘钝性腹部创伤后孤立性小肠系膜损伤罕见。撕裂为纵向或横向。应进行缝合修复。延迟就医或延迟诊断可能导致发病和死亡。对于任何因方向盘损伤导致钝性腹部创伤且不稳定患者无任何实体器官损伤证据的患者,均应考虑孤立性系膜损伤。

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本文引用的文献

1
Double ischemic ileal stenosis secondary to mesenteric injury after blunt abdominal trauma.钝性腹部创伤后肠系膜损伤继发的双发性缺血性回肠狭窄。
World J Gastroenterol. 2008 Jan 7;14(1):143-5. doi: 10.3748/wjg.14.143.
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Late small bowel obstruction after blunt abdominal trauma.钝性腹部创伤后晚期小肠梗阻
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Mesenteric injury after blunt abdominal trauma.钝性腹部创伤后肠系膜损伤。
Eur J Surg. 2001 Feb;167(2):106-9. doi: 10.1080/110241501750070547.
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Intestinal stenosis from mesenteric injury after blunt abdominal trauma.钝性腹部创伤后肠系膜损伤所致的肠道狭窄。
Eur Radiol. 1999;9(7):1429-31. doi: 10.1007/s003300050863.
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Blunt bowel and mesenteric injury: diagnostic performance of CT signs.钝性肠管及肠系膜损伤:CT征象的诊断效能
J Comput Assist Tomogr. 1997 Sep-Oct;21(5):706-12. doi: 10.1097/00004728-199709000-00005.
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Blunt injury of the small intestine and mesentery--the trauma surgeon's Achilles heel?小肠和肠系膜钝性损伤——创伤外科医生的致命弱点?
Eur J Emerg Med. 1996 Jun;3(2):85-91. doi: 10.1097/00063110-199606000-00005.
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Mesenteric injury from blunt abdominal trauma.钝性腹部创伤所致的肠系膜损伤。
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Blunt abdominal trauma. A 5-year analysis of 870 patients requiring celiotomy.钝性腹部创伤。对870例需要剖腹手术患者的5年分析。
Ann Surg. 1984 Apr;199(4):467-74. doi: 10.1097/00000658-198404000-00015.
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[Isolated lesion of the small intestine caused by a steering wheel].[方向盘导致的小肠孤立性损伤]
Ugeskr Laeger. 1970 Oct 29;132(44):2083-4.
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Ann Surg. 1985 Feb;201(2):198-203. doi: 10.1097/00000658-198502000-00011.