Vertruyen M, Nardini J, Bruyns J
Department of Digestive Surgery, Hôpital Universitaire St-Pierre, Brussels, Belgium.
Acta Chir Belg. 1995 Mar-Apr;95(2):76-80.
On account of two recent cases, the authors present a review of the literature of small bowel isolated perforations following blunt abdominal trauma. Although these injuries are quite rare and their management relatively easy, the diagnostic approach is often hazardous and may lengthen the operative delay, worsening morbidity and mortality. The authors review the various physiopathological mechanisms (deceleration, crushing and rupture phenomena) responsible for small bowel perforations, as well as the predisposing factors. They emphasize the multiple pitfalls of the diagnosis and try, through a study of the literature, to establish systematic guidelines. The advantages and deficiencies of the various complementary investigations are discussed. The authors conclude with indications of conservative treatments and segmentary enterectomies respectively.
鉴于最近的两例病例，作者对钝性腹部创伤后小肠孤立性穿孔的文献进行了综述。尽管这些损伤相当罕见且处理相对容易，但诊断方法往往具有危险性，可能会延长手术延迟时间，增加发病率和死亡率。作者回顾了导致小肠穿孔的各种生理病理机制（减速、挤压和破裂现象）以及诱发因素。他们强调了诊断中的多个陷阱，并试图通过文献研究建立系统的指导方针。讨论了各种辅助检查的优缺点。作者分别以保守治疗和节段性肠切除术的适应症作为结论。
