S状結腸被覆穿孔後に狭窄をきたした遷延性シートベルト外傷の1例

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  • A CASE OF SIGMOID COLON STENOSIS AFTER PERFORATION DUE TO DELAYED SEAT BELT INJURY

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We report a case of seat belt injury characterized by stenosis of the sigmoid colon after perforation. The patient was a 22-year-old male, who had crashed into a guard rail while driving and was admitted to a hospital. Since he was wearing a 3-point seat belt, he had no remarkable external injuries. However, he complained of an occasional dull pain in his left lower abdomen three days after the accident. His abdomen was soft and flat, and there were no abnormal signs which called for further examinaiton, so he was discharged from the hospital 18 days after the accident. However, the same symptom gradually became worse and he admitted to our hospital. Sigmoid colon stenosis was diagnosed after retrograde flouroscopy and colonoscopy were performed. Sigmoidectomy was performed 53 days after the accident. A covered perforation and stenosis (about 5cm) of the sigmoid colon were observed, so the stenotic part was resected. Seat belt injuries are usually classified into two types, acute and delayed one, dependent on the time of initial symptoms. This case falls into the latter, for it took a relatively long time for the symptoms to develop. Our discussion concentrates on the dalayed seat belt injuries.

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