交通事故による消化管穿孔例の検討 [in Japanese] CLINICAL STUDY ON GASTROINTESTINAL PERFORATION DUE TO TRAFFIC TRAUMA [in Japanese]
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Thirteen cases of gastrointestinal perforation due to a traffic trauma seen between November 1986 and October 1994 were reviewed for keys to diagnosis and treatment. Motor vehicle accident were involved in eight (62%) out of the 13 cases and seat-belts were in use in five cases (62%). The most common location of perforations was the small intestine (10 cases), followed by the duodenum ) (2 cases) and stomach (1 cases). Muscular defense was present in nine (69%) of 13 patients at the first medical examination, and in the remaining four cases it appeared 1 to 6 hours later. Free air was noted in only two (15%) patients, that appeared 6 hours after the accident. Partial resection of the small intestine was performed in eight cases, primary closure in four cases and extended gastrectomy in one case. A rise in pressure of the closed loop of the intestine which started from the Treitz ligament was thought as the origin of the perforation, because 80% of all intestinal perforations were located within 120cm from the Treitz ligament. If an early definitive diagnosis is made and an early treatment is performed, the prognosis of the traumatic intestinal perforation should be favorable. We have to keep the patient under the strict observation and not to let the timing of the operation go by.
- The journal of the Japanese Practical Surgeon Society
The journal of the Japanese Practical Surgeon Society 58(8), 1728-1732, 1997-08-25
Japan Surgical Association