Connolly D P, Ugwu B T, Eke B A
Department of Surgery, Jos University Teaching Hospital, Nigeria.
East Afr Med J. 1998 Jul;75(7):439-40.
The case of a 13-year old girl who presented with generalised peritonitis, septic shock and laboratory features of perforated typhoid enteritis is presented. At laparotomy 25 perforations involving the distal jejunum and the entire ileum were noted with extensive peritoneal soilage. The perforations were successfully closed in single layer using vicryl (polyglactin 910) sutures and the peritoneum thoroughly lavaged. The patient has been followed up for thirty months with only minimal complications. We believe that single layer closure of extensive multiple typhoid perforations in a poor risk patient when weighed against resection and anastomosis with the possibility of short bowel syndrome is safer, quicker and more effective as long as the procedure is undertaken after adequate resuscitation and under appropriate antibiotic cover.
本文报告了一名13岁女孩的病例，该女孩出现了弥漫性腹膜炎、感染性休克以及穿孔性伤寒肠炎的实验室特征。剖腹探查时发现25处穿孔，累及空肠远端和整个回肠，并伴有广泛的腹腔污染。使用薇乔（聚乙醇酸910）缝线成功单层缝合穿孔，并对腹腔进行了彻底冲洗。对该患者进行了30个月的随访，仅出现了轻微并发症。我们认为，对于高危患者广泛多发的伤寒穿孔，与可能导致短肠综合征的切除和吻合术相比，单层缝合在充分复苏后并在适当抗生素覆盖下进行，更安全、更快捷且更有效。
