Isolierte Ileumperforation nach stumpfem Bauchtrauma

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