Hara Kazushi, Yamamoto Manabu, Sakamoto Teruhisa, Sugezawa Ken, Uejima Chihiro, Tanio Akimitsu, Tada Yoichiro, Hanaki Takehiko, Miyatani Kozo, Watanabe Joji, Kihara Kyoichi, Tokuyasu Naruo, Takano Shuichi, Honjo Soichiro, Fujiwara Yoshiyuki
Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8503, Japan.
Surg Case Rep. 2020 May 26;6(1):115. doi: 10.1186/s40792-020-00874-1.
Small bowel stenosis after blunt abdominal trauma is relatively rare, and progression from trauma to bowel stenosis might sometimes be delayed. Herein, we report the case of a patient who was diagnosed with small bowel stenosis relatively early and received laparoscopic surgery.
An 18-year-old Japanese male was in a traffic accident and was urgently transported to our hospital. On arrival, he was admitted with right kidney and right adrenal injury and abdominal aortic aneurysm. On hospital day 13, he vomited during conservative treatment without surgery, and computed tomography revealed small bowel stenosis and dilatation of the oral-side small bowel. No improvement with the ileus tube occurred, and he received laparoscopic surgery on hospital day 21. Briefly, the abdominal cavity was observed with a laparoscope. The mesentery was congested, scarring around the stenotic small bowel regions was present, and three stenotic regions were observed 40-50 cm from the Treitz ligament. The patient received partial resection and anastomosis of the small bowel. The postoperative course was stable, and he was discharged on postoperative day eight.
Most cases of bowel stenosis after abdominal trauma are irreversible and usually require surgical treatment. Therefore, small bowel stenosis should be considered in patients with abdominal symptoms after blunt abdominal trauma.
钝性腹部创伤后小肠狭窄相对少见，从创伤发展到肠狭窄有时可能会延迟。在此，我们报告一例相对早期诊断为小肠狭窄并接受腹腔镜手术的患者病例。
一名18岁日本男性遭遇交通事故，被紧急送往我院。入院时，他被诊断为右肾和右肾上腺损伤以及腹主动脉瘤。在住院第13天，他在未进行手术的保守治疗期间呕吐，计算机断层扫描显示小肠狭窄及近端小肠扩张。放置肠梗阻导管后病情无改善，他于住院第21天接受了腹腔镜手术。简要过程如下，通过腹腔镜观察腹腔。肠系膜充血，狭窄小肠区域周围有瘢痕形成，在距屈氏韧带40 - 50厘米处观察到三个狭窄区域。患者接受了小肠部分切除及吻合术。术后病程平稳，术后第8天出院。
腹部创伤后肠狭窄的大多数病例是不可逆的，通常需要手术治疗。因此，钝性腹部创伤后出现腹部症状的患者应考虑小肠狭窄。
