Tayade Harshal, Khedkar Kiran, Lamture Yashwant, Dharmashi Jay
General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND.
Cureus. 2022 May 12;14(5):e24940. doi: 10.7759/cureus.24940. eCollection 2022 May.
Many surgeons are familiar with small bowel perforation-a breach in the continuity of the bowel wall resulting in spillage of contents into the peritoneal cavity. Usually, patients present with severe abdominal pain, and radiological investigations suggest pneumoperitoneum. However, intestinal perforation secondary to electrocautery used for umbilical granuloma excision is rare. We report a case of a 4-month-old boy who presented with primary concerns of constipation, severe abdominal pain, and multiple episodes of vomiting three days following an electrocautery excision of umbilical granuloma. An exploratory laparotomy revealed a perforation of the terminal ileum. Primary repair of the ileal perforation was done, which saved the infant's life. As this case illustrates, even a minor surgical procedure can lead to a major intraperitoneal injury, and appropriate evaluation based on clinical signs and symptoms is imperative. This case is also a reminder to handle an electrosurgical instrument with proper skill, training, and technical assistance.
许多外科医生都熟悉小肠穿孔——肠壁连续性的中断，导致内容物漏入腹腔。通常，患者会出现严重腹痛，影像学检查提示气腹。然而，用于脐肉芽肿切除的电灼术继发肠穿孔很少见。我们报告一例4个月大男孩，在脐肉芽肿电灼切除术后三天，主要表现为便秘、严重腹痛和多次呕吐。剖腹探查发现回肠末端穿孔。对回肠穿孔进行了一期修复，挽救了婴儿的生命。正如本病例所示，即使是一个小手术也可能导致严重的腹腔内损伤，基于临床症状和体征进行适当评估至关重要。本病例也提醒我们要以适当的技能、培训和技术支持来操作电外科器械。
