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Gepubliceerd in: Nederlands Tijdschrift voor Traumachirurgie 3/2009

01-06-2009 | Casus

Traumatische sigmoïdperforatie

Auteurs: K. J. Hartemink, D. L. van der Peet, M. A. Cuesta

Gepubliceerd in: Nederlands Tijdschrift voor Traumachirurgie | Uitgave 3/2009

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Samenvatting

Na een stomp buiktrauma geeft de aard van het trauma in combinatie met lichamelijk onderzoek en beeldvormende diagnostiek een indruk van de eventueel aanwezige letsels. Wij beschrijven een patiënte na een hoogenergetisch trauma met pijnklachten in de bovenbuik, een seatbelt sign en vrij lucht intra-abdominaal en retroperitoneaal, suspect voor letsel van het duodenum en het pancreas. Bij laparotomie blijkt er echter sprake te zijn van een sigmoïdperforatie. De discrepantie tussen lichamelijk onderzoek en beeldvormende diagnostiek enerzijds en de uiteindelijke peroperatieve bevindingen anderzijds wordt besproken, evenals de rol hierbij van beeldvormende diagnostiek en de beperkingen ervan. Er dient kritisch te worden gekeken naar het traumamechanisme, de klachten van de patiënt en het resultaat van lichamelijk en beeldvormend onderzoek alvorens een behandeling wordt ingezet.
Literatuur
1.
go back to reference Chandler CF, Lane JS, Waxman KS. Seatbelt sign following blunt trauma is associated with increased incidence of abdominal injury. Am Surg 1997;63:885-8. Chandler CF, Lane JS, Waxman KS. Seatbelt sign following blunt trauma is associated with increased incidence of abdominal injury. Am Surg 1997;63:885-8.
2.
go back to reference Hayes CW, Conway WF, Walsh J, e.a. Seat belt injuries: radiologic findings and clinical correlation. Radiographics 1991;11:23-36. Hayes CW, Conway WF, Walsh J, e.a. Seat belt injuries: radiologic findings and clinical correlation. Radiographics 1991;11:23-36.
3.
go back to reference Velmahos GC, Tatevossian R, Demetriades D. The ‘Seat belt marl’ sign: a call for increased vigilance among physicians treating victims of motor vehicle accidents. Am Surg 1999;65:181-5. Velmahos GC, Tatevossian R, Demetriades D. The ‘Seat belt marl’ sign: a call for increased vigilance among physicians treating victims of motor vehicle accidents. Am Surg 1999;65:181-5.
4.
go back to reference Williams MD, Watts D, Fakhry S. Colon injury after blunt abdominal trauma: results of the EAST multi-institutional hollow viscus injury study. J Trauma 2003;55:906-12. Williams MD, Watts D, Fakhry S. Colon injury after blunt abdominal trauma: results of the EAST multi-institutional hollow viscus injury study. J Trauma 2003;55:906-12.
5.
go back to reference Wiener I, Rojas P, Wolma FJ. Traumatic colonic perforation. Review of 16 years’ experience. Am J Surg 1981;142:717-20. Wiener I, Rojas P, Wolma FJ. Traumatic colonic perforation. Review of 16 years’ experience. Am J Surg 1981;142:717-20.
6.
go back to reference Albanese CT, Meza MP, Gardner MJ, e.a. Is computed tomography a useful adjunct to the clinical examination for the diagnosis of pediatric gastrointestinal perforation from blunt abdominal trauma in children. J Trauma 1996;40:417-21. Albanese CT, Meza MP, Gardner MJ, e.a. Is computed tomography a useful adjunct to the clinical examination for the diagnosis of pediatric gastrointestinal perforation from blunt abdominal trauma in children. J Trauma 1996;40:417-21.
7.
go back to reference Stuhlfaut JW, Soto JA, Lucey BC, e.a. Blunt abdominal trauma: performance of CT without oral contrast material. Radiology 2004;233:689-94. Stuhlfaut JW, Soto JA, Lucey BC, e.a. Blunt abdominal trauma: performance of CT without oral contrast material. Radiology 2004;233:689-94.
8.
go back to reference Killeen KL, Shanmuganathan K, Poletti PA, e.a. Helical computed tomography of bowel and mesenteric injuries. J Trauma 2001;51:26-36. Killeen KL, Shanmuganathan K, Poletti PA, e.a. Helical computed tomography of bowel and mesenteric injuries. J Trauma 2001;51:26-36.
9.
go back to reference Sherck J, Shatney C, Sensaki K. The accuracy of computed tomography in the diagnosis of blunt small-bowel perforation. Am J Surg 1994;168:670-5. Sherck J, Shatney C, Sensaki K. The accuracy of computed tomography in the diagnosis of blunt small-bowel perforation. Am J Surg 1994;168:670-5.
10.
go back to reference Ng AK, Simons RK, Torreggiani WC, e.a. Intra-abdominal free fluid without solid organ injury in blunt abdominal trauma: an indication for laparotomy. J Trauma 2002;5:1134-40. Ng AK, Simons RK, Torreggiani WC, e.a. Intra-abdominal free fluid without solid organ injury in blunt abdominal trauma: an indication for laparotomy. J Trauma 2002;5:1134-40.
11.
go back to reference Cunningham MA, Tyroch AH, Davis JW, e.a. Does free fluid on abdominal computed tomographic scan after blunt trauma require laparotomy? J Trauma 1998;44:599-602. Cunningham MA, Tyroch AH, Davis JW, e.a. Does free fluid on abdominal computed tomographic scan after blunt trauma require laparotomy? J Trauma 1998;44:599-602.
12.
go back to reference Livingston DH, Lavery RF, Passannante MR, e.a. Free fluid on abdominal computed tomography without solid organ injury after blunt abdominal injury does not mandate celiotomy. Am J Surg 2001;182:6-9. Livingston DH, Lavery RF, Passannante MR, e.a. Free fluid on abdominal computed tomography without solid organ injury after blunt abdominal injury does not mandate celiotomy. Am J Surg 2001;182:6-9.
13.
go back to reference Livingston DH, Lavery RF, Passannante MR, e.a. Admission or observation is not necessary after a negative abdominal computed tomographic scan in patients with suspected blunt abdominal trauma: results of a prospective, multi-institutional trial. J Trauma 1998;44:273-80. Livingston DH, Lavery RF, Passannante MR, e.a. Admission or observation is not necessary after a negative abdominal computed tomographic scan in patients with suspected blunt abdominal trauma: results of a prospective, multi-institutional trial. J Trauma 1998;44:273-80.
14.
go back to reference Venkatesh KR, McQuay N jr. Outcomes of management in stable children with intra-abdominal free fluid without solid organ injury after blunt abdominal injury. J Trauma 2007;62:216-20. Venkatesh KR, McQuay N jr. Outcomes of management in stable children with intra-abdominal free fluid without solid organ injury after blunt abdominal injury. J Trauma 2007;62:216-20.
15.
go back to reference Hughes TM, Elton C. The pathophysiology and management of bowel and mesenteric injuries due to blunt trauma. Injury 2002;33:295-302. Hughes TM, Elton C. The pathophysiology and management of bowel and mesenteric injuries due to blunt trauma. Injury 2002;33:295-302.
16.
go back to reference Sharma OP, Oswanski MF, Singer D, e.a. The role of computed tomography in diagnosis of blunt intestinal and mesenteric trauma (BIMT). J Emerg Med 2004;27:55-67. Sharma OP, Oswanski MF, Singer D, e.a. The role of computed tomography in diagnosis of blunt intestinal and mesenteric trauma (BIMT). J Emerg Med 2004;27:55-67.
17.
go back to reference Brofman N, Atri M, Epid D, e.a. Evaluation of bowel and mesenteric blunt trauma with multidetector CT. RadioGraphics 2006;26:1119-31. Brofman N, Atri M, Epid D, e.a. Evaluation of bowel and mesenteric blunt trauma with multidetector CT. RadioGraphics 2006;26:1119-31.
18.
go back to reference Scaglione M, Lutio di Castelguidone E de, Scialpi M, e.a. Blunt trauma to the gastrointestinal tract and mesentery: is there a role for helical CT in the decision-making process? Eur J Radiol 2004;50:67-73. Scaglione M, Lutio di Castelguidone E de, Scialpi M, e.a. Blunt trauma to the gastrointestinal tract and mesentery: is there a role for helical CT in the decision-making process? Eur J Radiol 2004;50:67-73.
19.
go back to reference Menegaux F, Trésallet C, Gosgnach M, e.a. Diagnosis of bowel and mesenteric injuries in blunt abdominal trauma: a prospective study. Am J Emerg Med 2006;24:19-24. Menegaux F, Trésallet C, Gosgnach M, e.a. Diagnosis of bowel and mesenteric injuries in blunt abdominal trauma: a prospective study. Am J Emerg Med 2006;24:19-24.
Metagegevens
Titel
Traumatische sigmoïdperforatie
Auteurs
K. J. Hartemink
D. L. van der Peet
M. A. Cuesta
Publicatiedatum
01-06-2009
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Nederlands Tijdschrift voor Traumachirurgie / Uitgave 3/2009
Print ISSN: 2214-8736
Elektronisch ISSN: 2214-8744
DOI
https://doi.org/10.1007/BF03081705

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