3岁儿童钝性腹部创伤致小肠完全横断1例

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports Pub Date : 2025-09-08 DOI:10.1016/j.epsc.2025.103103

Yoshitaka Ishiguro , Te-Hsiung Wang , Mari Sonoda , Masato Sato , Shigeru Ohtsuru , Akihiko Hirakawa

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引用次数: 0

摘要

儿童钝性腹部创伤后小肠完全横断极为罕见，这给诊断和治疗带来了挑战。一名3岁女孩疑似非意外钝性外伤后出现腹痛、呕吐和嗜睡。到达时，病人的生命体征显示心动过速和发烧。体格检查显示胸部和上腹部有淤血，腹部超声检查显示Morison's袋内有游离液体。实验室检查显示明显的转氨酶升高。增强计算机断层扫描显示肝周间隙和脾肾窝有自由空气和液体，无肝损伤迹象。诊断性腹腔镜检查证实，在Treitz韧带远端约2cm处出现完整的空肠横断，伴有污染的腹水，提示转开腹手术。切除约5cm的空肠，然后进行初级端到端吻合。术后过程顺利，患者于术后第6天转至儿童保护机构。随访15个月，恢复正常，无并发症。结论幼儿钝性腹部创伤可导致严重的肠道损伤，并可延迟表现。

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Complete transection of the small intestine due to blunt abdominal trauma in a 3-year-old child: a case report

Introduction

Complete transection of the small intestine following blunt abdominal trauma in children is extremely rare and poses diagnostic and therapeutic challenges.

Case presentation

A 3-year-old girl presented with abdominal pain, vomiting, and lethargy after suspected non-accidental blunt trauma. On arrival, the patient's vital signs showed tachycardia and fever. Physical examination revealed chest and epigastric ecchymoses, while abdominal ultrasonography revealed free fluid in Morison's pouch. Laboratory tests demonstrated marked transaminase elevation. Contrast-enhanced computed tomography showed free air and fluid in the perihepatic space and splenorenal fossa without evidence of liver injury. A diagnostic laparoscopy confirmed a complete jejunal transection approximately 2 cm distal to the ligament of Treitz with contaminated ascites, prompting conversion to open laparotomy. Approximately 5 cm of the jejunum were resected, followed by primary end-to-end anastomosis. The postoperative course was uneventful, and the patient was transferred to a child protection facility on postoperative day 6. Follow-up at 15 months confirmed normal recovery without complications.