Min Kyung-Jin, Im Hyesook, Lee Sanghoon, Hong Jin Hwa, Song Jae-Yun, Lee Jae-Kwan, Lee Nak Woo
Department of Obstetrics and Gynecology, Korea University Medical Center, Seoul, Korea.
Obstet Gynecol Sci. 2016 May;59(3):249-52. doi: 10.5468/ogs.2016.59.3.249. Epub 2016 May 13.
We describe an unusual case of delayed retropneumoperitoneum caused by a deep vaginal laceration as a result trauma from a water jet in a fountain. A 7-year-old premenarcheal girl presented to the emergency department after experiencing an injury from a water jet at a fountain park. Initially, the patient's vital sign and perineum were within normal range. Because the patient's vital signs became unstable 12 hours after vaginal injury, we carried out abdomino-pelvic computed tomography resulting in retropneumoperitoneum. Arterial bleeding from vaginal lateral wall was founded and controlled by electrocoagulation. No damage to the rectum was laparoscopically confirmed. A diagnostic laparoscopy, not laparotomy, should be considered in cases of retropneumoperitoneum with an ambiguous cause first.
我们描述了一例因喷泉中的水射流造成创伤，导致深部阴道撕裂伤引起迟发性腹膜后积气的罕见病例。一名7岁的青春期前女孩在喷泉公园被水射流致伤后被送往急诊科。最初，患者的生命体征和会阴部均在正常范围内。由于阴道损伤12小时后患者生命体征变得不稳定，我们进行了腹盆腔计算机断层扫描，结果显示有腹膜后积气。发现阴道侧壁动脉出血，并通过电凝法进行了控制。腹腔镜检查确认直肠未受损。对于病因不明的腹膜后积气病例，应首先考虑诊断性腹腔镜检查，而非剖腹手术。
