Graf D, Schuppisser J P, Tondelli P
Chirurgische Klinik, St. Claraspital Basel.
Chirurg. 1988 Sep;59(9):587-91.
This is a report about five patients who suffered a perforation of the colon during a barium-sulfate enema. In one case, barium leaked into the intraperitoneal cavity causing a barium peritonitis. In the other four cases, leakage into the retroperitoneal cavity occurred. All patients underwent surgical removal and drainage of the barium-sulfate and subsequently required a colostomy. In two cases a bowel resection was additionally performed. In one case the defect re-sutured. Antibiotic therapy was included in all cases. All patients survived the incident and were discharged between 20 days and four months postoperatively. Publications and personal experience led us to manage intraperitoneal or large retroperitoneal perforations by prompt laparotomy with removal of barium and faeces. A proximal colostomy is also required. In smaller retroperitoneal perforations conservative management is feasible, however, if the patient's condition deteriorates, they should be treated as recommended for an intraperitoneal perforation.
这是一份关于五例在硫酸钡灌肠过程中发生结肠穿孔患者的报告。其中一例，钡剂漏入腹腔导致钡剂性腹膜炎。另外四例发生了钡剂漏入腹膜后腔。所有患者均接受了手术清除和引流硫酸钡，随后均需要进行结肠造口术。两例还额外进行了肠切除术。一例对缺损进行了再次缝合。所有病例均采用了抗生素治疗。所有患者均在此次事件中存活，并在术后20天至四个月之间出院。出版物及个人经验使我们通过迅速剖腹手术清除钡剂和粪便来处理腹腔内或大的腹膜后穿孔。还需要进行近端结肠造口术。对于较小的腹膜后穿孔，保守治疗是可行的，但是，如果患者病情恶化，则应按照腹腔内穿孔的建议进行治疗。
