North Matthew, Aveyard Nicholas, Diya Oyeniyi, Berger Jeremy, Al-Whouhayb Maitham
Department of General Surgery, Barnet and Chase Farm Hospitals, Royal Free London NHS Foundation Trust, London, UK.
Case Rep Surg. 2017;2017:7639265. doi: 10.1155/2017/7639265. Epub 2017 Nov 26.
A 23-year-old male with a history of previous abdominal surgery was involved in a road traffic accident. He was discharged after initial assessment but represented several days with small bowel obstruction secondary to a mesenteric haematoma. He underwent resection and recovered well but represented later on the day of discharge with a leaking surgical wound consistent with an enterocutaneous fistula. This was managed conservatively and closed spontaneously after ten days. This case serves to highlight that adhesions from previous surgery can tether the small bowel causing mesenteric injury following blunt-force trauma. It also demonstrates that postoperative ileus can result in an enterocutaneous fistula that has the appearance of an anastomotic breakdown but which resolves more rapidly.
一名有腹部手术史的23岁男性遭遇了道路交通事故。他在初步评估后出院，但几天后因肠系膜血肿继发小肠梗阻再次就诊。他接受了切除术，恢复良好，但在出院当天晚些时候又出现了与肠皮肤瘘相符的手术伤口渗漏。对此进行了保守处理，十天后自行愈合。该病例旨在强调既往手术形成的粘连可束缚小肠，导致钝性创伤后肠系膜损伤。它还表明，术后肠梗阻可导致肠皮肤瘘，其外观类似吻合口破裂，但愈合更快。
