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儿童钝性腹部创伤伴发的胃肠道穿孔

Gastrointestinal Perforation with Blunt Abdominal Trauma in Children.

作者信息

Staab Victoriya, Naganathan Srividya, McGuire Margaret, Pinto Jamie M, Pall Harpreet

机构信息

Department of Surgery and Pediatrics, K. Hovnanian Children's Hospital at Jersey Shore University Medical Center, Neptune, NJ 07753, USA.

Department of Surgery and Pediatrics, Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA.

出版信息

Children (Basel). 2024 May 21;11(6):612. doi: 10.3390/children11060612.

Abstract

Gastrointestinal tract perforation is uncommon in children, accounting for <10% of cases of blunt abdominal trauma. Diagnosis of bowel perforation in children can be challenging due to poor diagnostic imaging accuracy. Intra-abdominal free air is found only in half of the children with bowel perforation. Ultrasound findings are nonspecific and suspicious for perforation in only two-thirds of cases. A computer tomography (CT) scan has a sensitivity and specificity of 50% and 95%, respectively. Surgical decisions should be made based on clinical examination despite normal CT results. Management of bowel perforation in children includes primary repair in 50-70% and resection with anastomosis in 20-40% of cases.

摘要

胃肠道穿孔在儿童中并不常见,占钝性腹部创伤病例的不到10%。由于诊断性影像学准确性较差,儿童肠道穿孔的诊断可能具有挑战性。仅一半的肠道穿孔儿童会出现腹腔内游离气体。超声检查结果不具有特异性,仅三分之二的病例对穿孔有可疑表现。计算机断层扫描(CT)的敏感性和特异性分别为50%和95%。尽管CT结果正常,仍应根据临床检查做出手术决策。儿童肠道穿孔的治疗包括50 - 70%的病例进行一期修复,20 - 40%的病例进行切除并吻合。

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Blunt Abdominal Trauma in Children: A Review of 105 Cases.儿童钝性腹部创伤:105例病例回顾
J Indian Assoc Pediatr Surg. 2023 Jan-Feb;28(1):48-53. doi: 10.4103/jiaps.jiaps_171_21. Epub 2023 Jan 10.
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Epidemiology and management of abdominal injuries in children.儿童腹部损伤的流行病学和处理。
Acad Emerg Med. 2022 Aug;29(8):944-953. doi: 10.1111/acem.14497. Epub 2022 Apr 23.
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Blunt abdominal trauma due to handlebar injury.因车把致伤的钝性腹部创伤。
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