Yusif-Zada Kanan, Safarov Rashad, Gafarov Azar
Ann Ital Chir. 2013 Nov-Dec;84(6):699-703.
Small bowel perforation from blunt abdominal trauma is a common injury. Isolated perforation of the small bowel after blunt abdominal trauma is infrequent and the diagnosis can be elusive. A case of isolated perforation from blunt trauma is presented. Deterioration of the clinical picture raised suspicion of acute abdomen, perforated sore. If acute abdomen is the case even with a history of minimal abdominal trauma, delayed intestinal trauma should be considered in the diagnosis. The uses of various diagnostic procedures, such as chest radiograph for free air, abdominal ultrasonography and computed tomography for diagnosing intestinal perforation was reviewed. Serial abdominal examination continued to be paramount in diagnosing intestinal injuries. Explorative laparotomy revealed the perforation on the antimesenteric border. Early surgical intervention leads to good recovery. Sufficient vigilance and suspicions of small bowel perforation should always be considered after blunt trauma even when symptoms and physical findings are minimal. Diagnostic difficulties result in delayed surgical treatment and eventually in increased morbidity and mortality.
钝性腹部创伤导致的小肠穿孔是一种常见损伤。钝性腹部创伤后单纯性小肠穿孔并不常见，诊断可能较为困难。本文介绍了一例钝性创伤导致的单纯性穿孔病例。临床表现恶化引发了对急腹症、穿孔性溃疡的怀疑。如果即使腹部创伤史轻微但出现急腹症情况，在诊断时应考虑延迟性肠损伤。回顾了各种诊断方法的应用，如用于检测游离气体的胸部X线片、用于诊断肠穿孔的腹部超声和计算机断层扫描。连续的腹部检查在诊断肠损伤中仍然至关重要。剖腹探查发现穿孔位于系膜缘对侧。早期手术干预可实现良好恢复。即使症状和体征轻微，钝性创伤后也应始终充分警惕并怀疑小肠穿孔。诊断困难会导致手术治疗延迟，最终增加发病率和死亡率。
