Nallathambi M N, Sleeper R, Smith M, Ivatury R R
Dis Colon Rectum. 1987 Jun;30(6):469-71. doi: 10.1007/BF02556499.
The case of a patient with acid burns of the large bowel from a self-administered enema of 95 percent sulfuric acid solution is reported. The authors were unable to find a similar case in the English medical literature. The patient presented in metabolic acidosis, and flexible sigmoidoscopy was of limited value. Peritoneal signs warranted early laparotomy, which revealed coagulation necrosis of the anus, rectum, and colon up to the hepatic flexure without any free perforation. The extent of damage was more severe than seen in the upper digestive tract from acid ingestion. Juxtaposed small bowel and the appendix sustained serosal burns. Subtotal proctocolectomy and perineal resection were done and the patient made an uneventful recovery. Early laparotomy is warranted, irrespective of endoscopic findings, for appropriate surgical correction.
报告了一例因自行灌肠95%硫酸溶液导致大肠酸烧伤的患者病例。作者在英文医学文献中未能找到类似病例。患者出现代谢性酸中毒，乙状结肠镜检查价值有限。腹膜刺激征提示应早期进行剖腹手术，术中发现肛门、直肠和结肠直至肝曲处有凝固性坏死，无游离穿孔。损伤程度比酸性物质摄入导致的上消化道损伤更严重。相邻的小肠和阑尾有浆膜烧伤。行直肠结肠次全切除术和会阴切除术，患者术后恢复顺利。无论内镜检查结果如何，为进行适当的手术矫正，均应早期进行剖腹手术。
