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病例报告:钝性腹部创伤所致肠梗阻的延迟表现

Case Report: Delayed Presentation of Bowel Obstruction Caused by Blunt Abdominal Trauma.

作者信息

George Nicholas H, Baldi Charles A, Tonascia James M, Moayedi Siamak

机构信息

University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland.

出版信息

Clin Pract Cases Emerg Med. 2020 Nov;4(4):620-622. doi: 10.5811/cpcem.2020.9.47034.

Abstract

INTRODUCTION

Bowel obstruction is a rare but well reported complication of blunt abdominal trauma (BAT). Obstruction is most often seen acutely caused by bowel wall hematomas and chronically as a result of post-traumatic strictures. Here, we present a novel case of BAT causing a subacute obstructing bowel wall hematoma.

CASE REPORT

A healthy, 32-year-old male presented to our emergency department with three days of nausea and vomiting. Chart review revealed he had been seen two weeks prior after a high-speed motor vehicle collision. During that initial visit, the patient had a benign abdominal exam and was discharged without imaging. On this return visit, the patient was found to have a large, obstructing colonic hematoma.

CONCLUSION

Because emergency physicians care for patients in both the acute and subacute phases of trauma, clinicians should recognize the more subtle sequelae of BAT.

摘要

引言

肠梗阻是钝性腹部创伤(BAT)一种罕见但有充分报道的并发症。梗阻最常急性见于肠壁血肿,慢性则是创伤后狭窄的结果。在此,我们报告一例由BAT导致亚急性梗阻性肠壁血肿的新病例。

病例报告

一名32岁健康男性因三天的恶心和呕吐就诊于我院急诊科。病历回顾显示,他在两周前发生高速机动车碰撞后前来就诊。在初次就诊时,患者腹部检查正常,未行影像学检查即出院。此次复诊时,发现患者有一个巨大的梗阻性结肠血肿。

结论

由于急诊医生在创伤的急性期和亚急性期都要诊治患者,临床医生应认识到BAT更隐匿的后遗症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8798/7676803/426eca7c0654/cpcem-04-620-g001.jpg

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