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[儿童因穿刺导致经肛门小肠脱出:1例报告]

[Transanal evisceration of small bowel caused by impalement in children: about a case].

作者信息

Wellé Ibrahima Bocar, Mbaye Pape Alassane, Séck Ndéye Fatou, Ndoye Ndéye Aby, Guéye Doudou, Lo Faty Balla, Ndiaye Modou, Sylla Mouhamed Aly, Sagna Aloise, Ngom Gabriel

机构信息

Service de Chirurgie Pédiatrique, Hôpital d'Enfant Albert Royer, Sénégal.

Service de Chirurgie Générale, Hôpital de Ourossogui, Sénégal.

出版信息

Pan Afr Med J. 2020 Dec 7;37:320. doi: 10.11604/pamj.2020.37.320.18332. eCollection 2020.

Abstract

Transanal evisceration of the small intestine caused by impalement is exceptional among children. We report the case of an 11-year old girl with intestinal loops eviscerating through the anus due to a fall on a sharp piece of wood which stuck into her, occurring two hours before hospitalization. On examination, his general condition was good, with transanal evisceration of approximately 25 cm of viable small bowel through the anus and abdominal tenderness. Preoperative laboratory tests were normal and no imaging test was performed. After resuscitation, surgical exploration was performed which showed serohematic fluid collection (300 ml) and evisceration of approximately 60 cm of inflammated intestinal loops through a rupture of approximately 5 cm of the anterior wall of the rectum. Reduction of the eviscerated intestinal loops by gentle traction, repair of the rectal wall by separated sutures, wash and drainage were performed. The patient received broad-spectrum antibiotic. The operating suites were simple with a resumption of transit two days after surgery. The patient was discharged seven days after surgery. After a follow-up period of one month, the patient came for a further consultation and clinical examination was normal.

摘要

因刺伤导致的经肛门小肠脱出在儿童中极为罕见。我们报告一例11岁女孩的病例,她因摔倒在一根刺入其身体的尖锐木片上,在住院前两小时出现肠袢经肛门脱出。检查时,她的一般状况良好,经肛门脱出约25厘米存活的小肠,并有腹部压痛。术前实验室检查正常,未进行影像学检查。复苏后进行了手术探查,发现有血清血液积聚(300毫升),约60厘米发炎的肠袢通过直肠前壁约5厘米的破裂处脱出。通过轻柔牵引将脱出的肠袢复位,用间断缝合修复直肠壁,进行冲洗和引流。患者接受了广谱抗生素治疗。手术操作简单,术后两天恢复排便。患者术后七天出院。经过一个月的随访期后,患者前来进一步会诊,临床检查正常。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2633/7896525/781a729abd08/PAMJ-37-320-g001.jpg

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