Kleanthis Anastasiadis, Mouravas Vasilis, Lampropoulos Vasilis, Babatseva Evgenia, Spyridakis Ioannis
Paediatric Surgeon, 2 Department of Paediatric Surgery, Aristotle University of Thessaloniki, General Hospital Papageorgiou, Thessaloniki, Greece.
Paediatrician, Neonatologist, 2 Department of Neonatal Intensive Care, Aristotle University of Thessaloniki, General Hospital Papageorgiou, Thessaloniki, Greece.
Pan Afr Med J. 2017 Jul 5;27:173. doi: 10.11604/pamj.2017.27.173.12430. eCollection 2017.
Blunt abdominal injury in children can be a significant diagnostic and therapeutic challenge. The extent and localization of organ damage cannot be always thoroughly investigated noninvasively and in spite of modern imaging techniques and a laparotomy may be necessary for diagnosis, even though it carries a significant morbidity. We present a rare case of isolated gastric rupture after blunt abdominal injury in a 12 year old boy that sustained a bicycle accident. He was hemodynamically stable, had signs of acute abdomen and axial tomography was inconclusive as of the site of visceral perforation. Definitive diagnosis and treatment were carried out laparoscopically with excellent results. Laparoscopic surgery in cases of blunt abdominal injury with gastric rupture can serve both as a diagnostic and therapeutic modality with the additional advantage of being less traumatic. The accumulation of relevant experience is mandatory in order to establish this modality in the diagnostic and therapeutic protocols.
儿童钝性腹部损伤可能是一个重大的诊断和治疗挑战。尽管有现代成像技术,但器官损伤的程度和部位并非总能通过无创方式进行全面检查,而且尽管剖腹手术有较高的发病率,但可能仍有必要进行诊断。我们报告了一例罕见的病例,一名12岁男孩在自行车事故中遭受钝性腹部损伤后出现孤立性胃破裂。他血流动力学稳定,有急腹症体征,轴向断层扫描对于内脏穿孔部位的诊断并不明确。通过腹腔镜进行了明确的诊断和治疗,效果良好。对于钝性腹部损伤合并胃破裂的病例,腹腔镜手术既可以作为诊断手段,也可以作为治疗方式,还有创伤较小的额外优势。为了在诊断和治疗方案中确立这种方式,积累相关经验是必不可少的。