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钝性腹部创伤导致降结肠完全横断。

Complete transection of the descending colon following blunt abdominal trauma.

机构信息

Acute Surgical Unit, Northern Sydney Local Health District, St Leonards, New South Wales, Australia

Acute Surgical Unit, Northern Sydney Local Health District, St Leonards, New South Wales, Australia.

出版信息

BMJ Case Rep. 2023 Jun 6;16(6):e254553. doi: 10.1136/bcr-2023-254553.

Abstract

We present the case of a man in his 30s who was crushed between two vehicles sustaining blunt trauma to his lower limbs and torso. The patient was in shock on arrival to the emergency department, and immediate resuscitation was given with massive transfusion protocol activation. Once the patient's haemodynamic status was stabilised, a CT scan revealed a complete colon transection. The patient was taken to the operating theatre where a midline laparotomy was performed, and the transected descending colon was managed with a segmental resection and handsewn anastomosis. The patient followed an unremarkable postoperative course, with bowels opening on day 8 postoperatively. Colon injuries are rare following blunt abdominal trauma, and a delay in diagnosis may lead to increased morbidity and mortality. As such, a low threshold for surgical intervention is recommended.

摘要

我们报告了一位 30 多岁男性的病例,他被两辆车辆挤压,下肢和躯干受到钝性创伤。患者到达急诊室时休克,立即给予复苏,并启动大量输血方案。患者血流动力学状态稳定后,CT 扫描显示完全结肠横断。患者被送往手术室,行正中剖腹术,横断的降结肠行节段切除和手工吻合。患者术后恢复顺利,术后第 8 天排便。钝性腹部创伤后结肠损伤罕见,诊断延迟可能导致发病率和死亡率增加。因此,建议手术干预的门槛较低。

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