Abstract:
A 46-year-old man presented with a small bowel prolapsing through the anus after straining on the toilet, which was starting to become ischaemic. He admitted to inserting a plastic object in his rectum about half an hour before straining. The bowel was kept moist by placing an intravenous drip line with saline dripping onto a wet swab. In theatre, the bowel was found to be prolapsing through a hole in the upper rectum and out through the anus. It was reduced back into the abdominal cavity through the same perforation, which was 4 cm long, without needing to extend it. This was sutured with polydioxanone (PDS) 2-0 as there was no contamination with faeces or pus. Due to improvement in the appearance of a small bowel and an extremely bruised mesentery, a re-look was planned in 24 hours. At the re-look the small bowel appeared healthy, therefore no resection was performed. However, a loop colostomy was fashioned to protect the upper rectal perforation repair. This shows that resection is not always required in such cases.
摘要:
一名46岁的男子在厕所紧张后出现小肠脱出肛门,开始成为缺血性疾病。他承认在拉伤前约半小时将一个塑料物体插入直肠。通过将具有盐水的静脉滴注管线滴到湿拭子上,使肠保持湿润。在剧院,发现肠通过上直肠的一个孔脱出,并通过肛门脱出。它通过同样的穿孔减少到腹腔,长4厘米,不需要延长它。用聚二恶烷酮(PDS)2-0缝合,因为没有粪便或脓液污染。由于小肠外观的改善和肠系膜的严重瘀伤,计划在24小时内重新审视。重新看小肠看起来很健康,因此没有进行切除.然而,环形结肠造口术是为了保护上直肠穿孔修复术。这表明在这种情况下并不总是需要切除。