METHODS: Previously healthy 48-year-old male presented to the emergency department following falling from 15 feats height. He was a paraplegic with a sensory level at T12. He did not have a clinical feature of spinal shock. He was complaining of epigastric and central abdominal pain and tenderness and was diagnosed to have a proximal Jejunal perforation associated with an unstable fracture of T12 causing spinal compression. Open intestinal repair followed by a posterior spinal exploration and pedicle screw fixation done.
UNASSIGNED: Violent injury due to different mechanisms can have similar injuries to Seat belt syndrome. Ultrasonography is used to detect pneumoperitoneum, but the Contrast study is the gold standard to detect visceral injuries. The surgical approach to visceral injury depends on the patient\'s condition. But the laparoscopic approach has a more favorable postoperative outcome than open access.
CONCLUSIONS: Intestinal perforations associated with the neurological deficit are difficult to identify in an initial clinical assessment. Thoracolumbar fractures can associate with small bowel injuries during high-velocity trauma. Early identification and repair of the intestinal injury are important to prevent devastating complications and to improve neurological recovery after spinal surgery.
方法:以前健康的48岁男性从15壮举高度跌落后出现在急诊科。他是截瘫患者,感觉水平为T12。他没有脊柱休克的临床特征。他抱怨上腹部和中央腹部疼痛和压痛,并被诊断为近端空肠穿孔与T12不稳定骨折相关,导致脊柱压迫。开放肠道修复,然后进行后路脊柱探查和椎弓根螺钉固定。
UNASSIGNED:由于不同机制造成的暴力伤害可能与安全带综合征有类似的伤害。超声检查用于检测气腹,但对比研究是检测内脏损伤的黄金标准。内脏损伤的手术方法取决于患者的病情。但是腹腔镜入路比开放入路具有更有利的术后效果。
结论:在最初的临床评估中很难确定与神经功能缺损相关的肠穿孔。胸腰椎骨折可与高速创伤期间的小肠损伤相关。肠损伤的早期识别和修复对于预防破坏性并发症和改善脊柱手术后的神经系统恢复非常重要。