[一名 9 岁儿童的外伤性胆囊破裂]。

Q4 Medicine
R Kh Shangareeva, I G Chendulaeva, V D Kovaleva, A A Salimgareev
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引用次数: 0

摘要

我们介绍了外伤后胆囊破裂的情况。一名 9 岁男孩在受伤 1.5 小时后入院。考虑到临床和超声波数据,我们诊断为外伤性脾脏损伤和血性腹腔积液、胆汁运动障碍、胆汁淤积。进行了止血治疗。3 天后,腹膜炎症状出现。随访超声检查显示胆囊肿大,内容物不均质,腹腔各处均有积液。术中,胆囊被浸泡在胆汁中的网膜包裹。在移动胆囊后,我们发现了长达 3 厘米的纵向线性撕裂,被网膜堵塞。于是进行了胆囊切除术。因此,我们要介绍的是一名合并脾脏损伤的患者。然而,胆囊壁增厚和异质内容物被解释为并发症。腹膜炎的延迟表现是由于胆囊被网膜包裹。最后一个浸泡在胆汁中的胆囊部分通过穿孔进入胆囊,阻止了胆汁渗入腹腔。胆囊损伤的及时诊断存在一定的困难,尤其是在合并损伤的情况下。在本病例中,外伤性胆囊破裂的超声波征象是胆囊壁增厚、内容物异质和胆囊逐渐增大。对于合并外伤的患者,有必要对损伤部位的所有器官进行分析,包括计算机断层扫描。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Traumatic gallbladder rupture in a 9-year-old child].

We present gallbladder rupture following trauma. A 9-year-old boy admitted in 1.5 hours after injury. Considering clinical and ultrasound data, we diagnosed traumatic damage to the spleen and hemoperitoneum, biliary dyskinesia, cholestasis, sludge. Hemostatic therapy was carried out. After 3 days, signs of peritonitis appeared. Follow-up ultrasound revealed gallbladder enlargement with heterogeneous content, fluid in all parts of abdominal cavity. Intraoperatively, the gallbladder was enveloped in omentum soaked in bile. After mobilization of the gallbladder, we found longitudinal linear tear up to 3 cm clogged with omentum. Cholecystectomy was performed. Thus, we present a patient with combined injury and damage to the spleen. However, gallbladder wall thickening and heterogeneous content were interpreted as concomitant pathology. Delayed manifestation of peritonitis was due to gallbladder enveloped in omentum. The last one soaked in bile partially entered the gallbladder through perforation and prevented bile leakage into abdominal cavity. Timely diagnosis of gallbladder damage presents certain difficulties, especially in case of combined injury. Ultrasound signs of traumatic gallbladder rupture in this case were wall thickening, heterogeneous content and gradual gallbladder enlargement. It is necessary to analyze all organs at the damage site including computed tomography in patients with combined trauma.

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来源期刊
Khirurgiya
Khirurgiya Medicine-Medicine (all)
CiteScore
0.70
自引率
0.00%
发文量
161
期刊介绍: Хирургия отдельных областей сердце, сосуды легкие пищевод молочная железа желудок и двенадцатиперстная кишка кишечник желчевыводящие пути печень
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