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喷气式滑水车事故继发的严重肛门直肠损伤:一种重要且日益增多的损伤机制。

Severe anorectal injury secondary to jet ski accident: An important and increasing mechanism of injury.

作者信息

Morice Donald, Stokes Matthew A R, Davey James, Skinner Stewart

机构信息

Frankston Hospital, 2 Hastings Road, Frankston, Victoria 3199, Australia.

出版信息

Trauma Case Rep. 2022 Oct 4;42:100703. doi: 10.1016/j.tcr.2022.100703. eCollection 2022 Dec.

Abstract

INTRODUCTION

Traumatic injuries from jet ski-related accidents have increased in incidence over the past few decades. Anorectal injuries are uncommon but typically arise from high-speed jet ski accidents. We present a case of a severe anorectal injury from a fall off the back of an accelerating jet ski.

CASE REPORT

This case reports on the presentation, operative findings and management of a 22-year-old female with major internal and external anal sphincter disruption sustained via an unusual traumatic mechanism. Operative findings identified a complete internal and external anal sphincter disruption at the 1 and 7 O'clock positions and extra-peritoneal rectal perforation. Washout, suture repair and an end-colostomy were performed.

CONCLUSION

Understanding the potential severity of injury from the insult mechanism is paramount to triaging and managing trauma patients. Although this case describes an inconspicuous mechanism, the resulting trauma is significant and should prompt consideration in future cases. In addition, the article describes an approach to the repair of such injuries and the difficult decision relating to the role and type of defunctioning colostomy to protect any possible missed injuries in a complex traumatic environment, and in the protection of the anorectal repair.

摘要

引言

在过去几十年中,与喷气式滑水车相关事故造成的创伤性损伤发生率有所上升。肛门直肠损伤并不常见,但通常发生在高速喷气式滑水车事故中。我们报告一例因从加速行驶的喷气式滑水车后部跌落导致的严重肛门直肠损伤病例。

病例报告

本病例报告了一名22岁女性的临床表现、手术发现及治疗情况,该患者通过一种不寻常的创伤机制导致肛门内外括约肌严重受损。手术发现肛门内外括约肌在1点和7点位置完全断裂,直肠腹膜外穿孔。进行了冲洗、缝合修复及末端结肠造口术。

结论

了解损伤机制导致的潜在严重程度对于创伤患者的分诊和管理至关重要。尽管本病例描述的损伤机制并不明显,但造成的创伤很严重,在未来病例中应予以重视。此外,本文描述了修复此类损伤的方法,以及在复杂创伤环境中关于造口术的作用和类型的艰难决策,以保护任何可能遗漏的损伤,并保护肛门直肠修复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0db/9573912/b8f35cd50587/gr1.jpg

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