頁籤選單縮合
題 名 | Pneumatic Perforation of the Colon by compressed Air--A Case Report=壓縮空氣造成充氣性大腸穿孔--一病例報告 |
---|---|
作 者 | 陳芳銘; 陳漢文; 黃宗人; | 書刊名 | 中華民國大腸直腸外科醫學會雜誌 |
卷 期 | 9:1 1998.03[民87.03] |
頁 次 | 頁37-40 |
分類號 | 416.245 |
關鍵詞 | 充氣性大腸穿孔; Compressed air; Pneumatic perforation of colon; Pneumoperitoneum; Hartmann's procedure; |
語 文 | 英文(English) |
中文摘要 | 在大腸穿孔的成因中,因壓縮空氣而造成的充氣性大腸穿孔,相當少見。一位四 十七歲的男性塗裝工人,被他的同事開玩笑地以壓縮空氣噴嘴貼著工作褲,朝二股之間噴了 一下之後,突感劇烈的腹脹及腹痛,而被緊急送醫。到院後,理學檢查顯示一典型的腹膜炎 併極度腹脹,而胸、腹部 X 光片則顯示大量的腹腔內游離空氣。 在腸穿孔併發腹膜炎的診 斷之下,患者接受了緊急剖腹探查術。術中發現於乙狀結腸與直腸交接處,在一 5 × 3 公 分的不規則穿孔,而遠端的直腸壁亦呈瘀血浮腫,且於漿膜肌肉層有多處撕裂傷。在施行了 Hartmann's 術式後,病人恢復順利,並於半年後返院接受結腸造口修復術。 充氣性大腸穿 孔是一種工業性傷害。人體的腸壁在腸腔內壓力達 4.07 Psi 時,便可能發生穿孔破裂。而 工業用的壓縮空氣,壓力介於 50-150 Psi 之間,在此高壓力下,氣柱便如同一根硬棒,在 導入肛門後,極易於腸道轉彎處,如乙狀結腸與直腸交接處,造成穿孔。此病症的診斷,主 要是靠正確的病史, 若理學檢查有腹膜炎的跡象,或 X 光攝影呈現腹腔內游離空氣時,則 建議立即行剖腹探查,依大腸原則處理,預後一般均佳。 |
英文摘要 | Pneumatic perforation of the colon by compressed air is an uncommon but potentially lethal injury. A 47-year-old man was admitted of pneumoperitoneum. The presentation was the result of a prank-his work mate held a nozzle from a compressed air machine against his fully clad buttock. At laparotomy, a 5×3 cm free perforation in the rectosigmoid colon and multiple longitudinal rents in the rectum were found. Hartmann's procedure was performed. After operation, the patient recovered smoothly. He was discharged on the eleventh day. Colostomy closure was performed six months after discharge. Literature on this condition is reviewed. |
本系統中英文摘要資訊取自各篇刊載內容。