Zusammenfassung
Perforierende Dünndarmverletzungen nach stumpfem Bauchtrauma sind selten. Insbesondere
als isolierte Verletzungen stellen sie eine diagnostische Herausforderung dar und
können durch Verzögerung der Diagnosestellung und der Therapie den Verlauf komplizieren.
Wir berichten über eine isolierte Ileumperforation nach stumpfem Abdominaltrauma im
Rahmen eines häuslichen Unfalles.
Abstract
Perforating injuries to the small bowel due to a blunt abdominal trauma are rare.
Especially in the case of an isolated injury where diagnostic investigations have
failed, it may result in delayed therapy and a prolonged clinical course. Here, we
report on an isolated ileal perforation caused by a blunt abdominal trauma in setting
of a domestic accident.
Schlüsselwörter
Abdominalchirurgie - abdomineller Notfalleingriff - stumpfes Abdominaltrauma - Darmperforation
- Computertomografie - explorative Laparotomie
Key words
abdominal surgery - blunt trauma - bowel perforation - computed tomography - exploratory
laparotomy - emergency abdominal operation
Literatur
- 1
Robbs J V, Moore S W, Pillay S P.
Blunt abdominal trauma with jejunal injury: A review.
J Trauma.
1980;
20
308-311
- 2
Cripps N PJ, Cooper G J.
Intestinal injury mechanisms after blunt abdominal impact.
Ann R Coll Surg Engl.
1997;
79
115-120
- 3
Ekeh A P, Saxe J, Walusimbi M et al.
Diagnosis of blunt intestinal and mesenteric injury in the era of multidetector CT
technology – are results better?.
J Trauma.
2008;
65
354-359
- 4
Fakhry S M, Watts D D, Luchette F A. EAST Multi-Institutional Hollow Viscus Injury
Research Group .
Current diagnostic approaches lack sensitivity in the diagnosis of perforated blunt
small bowel injury: analysis from 275 557 trauma admissions from the EAST multi-institutional
HVI trial.
J Trauma.
2003;
54
295-306
- 5
Fakhry S M, Brownstein M, Watts D D et al.
Relatively short diagnostic delays (< 8 hours) produce morbidity and mortality in
blunt small bowel injury: an analysis of time to operative intervention in 198 patients
from a multicenter experience.
J Trauma.
2000;
48
408-414
- 6
Hoff W S, Holevar M, Nagy K K et al.
EAST Practice Management Guidelines for the Evaluation of Blunt Abdominal Trauma:
The EAST Practice Management Guidelines Work Group.
J Trauma.
2002;
53
602-615
Dr. Andrej Ring
St. Josefs Hospital Dortmund-Süd · Chirurgie
Wilhelm-Schmidt-Str. 4
44263 Dortmund
Deutschland
Phone: 02 31 / 43 42 35 94
Fax: 02 31 / 43 42 22 01
Email: andrej.ring@ruhr-uni-bochum.de