エアコンプレッサーにより直腸損傷,縦隔気腫をきたした1例  [in Japanese] A Rare Case of Rectal Injury and Pneumomediastinum Caused by Compressed Air  [in Japanese]

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Abstract

<p>症例は62歳の男性で,職場の同僚に作業場にある工業用エアコンプレッサーを殿部にむけ噴射され受傷し,当院に来院した。エアコンプレッサーと患者の殿部との距離は約50cm離れており,患者は長ズボンと下着を着用していた。来院時頸部から前胸部にかけての皮下気腫と下腹部に反跳痛を伴う圧痛を認めた。胸腹部CTで直腸穿孔による後腹膜気腫,縦隔気腫,皮下気腫への進展と診断し,緊急開腹術を行った。開腹したところ,腹膜反転部直上から約4cm口側にわたって直腸間膜対側に腸管軸方向に漿膜筋層の裂創と,その裂創の一部に全層性の穿孔部位を認め,Hartmann手術を施行した。術後,縦隔炎や後腹膜膿瘍を形成することはなく,第23病日に退院となった。エアコンプレッサー自体を肛門に挿入せずに,患者とある程度の距離から送気されたとしても,十分に直腸損傷を生じる可能性があると考えられた。</p>

<p>A 62-year-old man was admitted to our hospital with an injury caused by high-pressure air from a compressor, which had been applied to his buttocks via a compressor gun by his colleague while they were working. His buttocks were 50 cm from the compressed air gun, which was notably not inserted into his anus as he was wearing trousers. When he was admitted, extensive subcutaneous emphysema was noted in his neck and thoracic region and he complained of lower abdominal pain with the peritoneal irritation sign. Computed tomography revealed rectal injury, pneumoretroperitoneum, and pneumomediastinum. The patient underwent emergency celiotomy, which revealed a 4cm linear laceration of the rectum over the antimesenteric border, with a full thickness injury: thus, Hartmann's operation was performed. The pneumomediastinum disappeared. The patient had an uneventful recovery and was discharged on postoperative day 23. It is important to realize that this type of injury can occur even without inserting a compressed air gun into the anus.</p>

Journal

  • Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine)

    Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) 37(6), 919-921, 2017

    Japanese Society for Abdominal Emergency Medicine

Codes

  • NII Article ID (NAID)
    130006404966
  • Text Lang
    JPN
  • ISSN
    1340-2242
  • Data Source
    J-STAGE 
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