Compressed air has been generally used since the beginning of the 20 th century for various applications. However, rupture of the colon caused by compressed air is uncommon. We report a case of pneumatic rupture of th...Compressed air has been generally used since the beginning of the 20 th century for various applications. However, rupture of the colon caused by compressed air is uncommon. We report a case of pneumatic rupture of the sigmoid colon. The patient was admitted to the emergency room complaining of abdominal pain and distention. His colleague triggered a compressed air nozzle against his anus as a practical joke 2 h previously. On arrival, his pulse rate was 126 beats/min, respiratory rate was 42 breaths/min and blood pressure was 86/54 mm Hg. Physical examination revealed peritoneal irritation and the abdomen was markedly distended. Computed tomography of the abdomen showed a large volume of air in the abdominal cavity. Peritoneocentesis was performed to relieve the tension pneumoperitoneum. Emergency laparotomy was done after controlling shock. Laparotomy revealed a 2-cm perforation in the sigmoid colon. The perforation was sutured and temporary ileostomy was performed as well as thorough drainage and irrigation of the abdominopelvic cavity. Reversal of ileostomy was performed successfully after 3 mo. Follow-up was uneventful. We also present a brief literature review.展开更多
目的报道并分析2例汽车腹部安全带综合征致小肠—肠系膜破裂大出血死亡的道路交通事故的成伤机制、死因,以及汽车腹部安全带的作用,为道路交通事故的法医学鉴定、伤者的救治和预防及汽车安全带的设计提供建议。方法收集本教研室鉴定的2...目的报道并分析2例汽车腹部安全带综合征致小肠—肠系膜破裂大出血死亡的道路交通事故的成伤机制、死因,以及汽车腹部安全带的作用,为道路交通事故的法医学鉴定、伤者的救治和预防及汽车安全带的设计提供建议。方法收集本教研室鉴定的2例道路交通事故致死案例,基于《国际疾病分类》(international classification of diseases,ICD)死因分析观点,综合分析损伤、疾病和饮酒等多因素共同作用致死的法医学事实因果关系及其原因力,从损伤后果探讨减少伤害的预防措施。结果提示汽车腹部安全带对于腹部及腹腔内脏软组织的保护作用存在一定的缺陷,易造成腹腔大出血死亡。结论对于道路交通伤害,除了重点关注重要器官致命伤及其致伤物和成伤机制之外,还需注意腹部小肠—肠系膜是否破裂出血,防止延误救治,及早预防,提高治愈率。同时建议汽车制造商进一步改进安全带等司乘人员保护设施的设计,提升汽车腹部安全带的保护作用。展开更多
文摘Compressed air has been generally used since the beginning of the 20 th century for various applications. However, rupture of the colon caused by compressed air is uncommon. We report a case of pneumatic rupture of the sigmoid colon. The patient was admitted to the emergency room complaining of abdominal pain and distention. His colleague triggered a compressed air nozzle against his anus as a practical joke 2 h previously. On arrival, his pulse rate was 126 beats/min, respiratory rate was 42 breaths/min and blood pressure was 86/54 mm Hg. Physical examination revealed peritoneal irritation and the abdomen was markedly distended. Computed tomography of the abdomen showed a large volume of air in the abdominal cavity. Peritoneocentesis was performed to relieve the tension pneumoperitoneum. Emergency laparotomy was done after controlling shock. Laparotomy revealed a 2-cm perforation in the sigmoid colon. The perforation was sutured and temporary ileostomy was performed as well as thorough drainage and irrigation of the abdominopelvic cavity. Reversal of ileostomy was performed successfully after 3 mo. Follow-up was uneventful. We also present a brief literature review.
文摘腹腔感染(intra-abdominal infection,IAI)是一种危害严重的常见感染性疾病,主要来源于空腔脏器的穿孔或破裂,消化道内容物进入腹腔内引起腹膜炎或腹腔脓肿,严重腹腔感染常合并脓毒症、脓毒性休克,是重症监护室(ICU)中主要的致死性病因,严重者可导致多脏器功能障碍综合征(multiple organ dysfunction syndrome,MODS),病死率高达10%~40%[1]。
文摘目的报道并分析2例汽车腹部安全带综合征致小肠—肠系膜破裂大出血死亡的道路交通事故的成伤机制、死因,以及汽车腹部安全带的作用,为道路交通事故的法医学鉴定、伤者的救治和预防及汽车安全带的设计提供建议。方法收集本教研室鉴定的2例道路交通事故致死案例,基于《国际疾病分类》(international classification of diseases,ICD)死因分析观点,综合分析损伤、疾病和饮酒等多因素共同作用致死的法医学事实因果关系及其原因力,从损伤后果探讨减少伤害的预防措施。结果提示汽车腹部安全带对于腹部及腹腔内脏软组织的保护作用存在一定的缺陷,易造成腹腔大出血死亡。结论对于道路交通伤害,除了重点关注重要器官致命伤及其致伤物和成伤机制之外,还需注意腹部小肠—肠系膜是否破裂出血,防止延误救治,及早预防,提高治愈率。同时建议汽车制造商进一步改进安全带等司乘人员保护设施的设计,提升汽车腹部安全带的保护作用。
