首页|Stress-induced intestinal necrosis resulting from severe trauma of an earthquake
Stress-induced intestinal necrosis resulting from severe trauma of an earthquake
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维普
AIM:To investigate the possible reasons and suggest therapeutic plan of stress-induced intestinal necrosis resulting from the severe trauma.METHODS:Three patients in our study were trapped inside collapsed structures for 22,21 and 37 h,respectively.The patients underwent 3-4 operations after sustaining their injuries.Mechanical ventilation,intermittent hemodialysis and other treatments were also provided.The patients showed signs of peritoneal irritation on postoperative days 10-38.Small intestinal necrosis was confirmed by emergency laparotomy,and for each patient,part of the small bowel was removed.RESULTS:Two patients who all performed 3 operations died of respiratory complications on the first and second postoperative days respectively.The third patient who performed 4 operations was discharged and made a full recovery.Three patients had the following common characteristics:(1) Multiple severe trauma events with no direct penetrating gastrointestinal injury; (2) Multiple surgeries with impaired renal function and intermittent hemodialysis treatment; (3) Progressive abdominal pain and tenderness,and peritoneal irritation was present on post-traumatic days 10-38; (4)Abdominal operations confirmed segment ulcer,necrosis of the small intestine,hyperplasia and stiffness of the intestinal wall; and (5) Pathological examinations suggested submucosal hemorrhage,necrosis,fibrosis and hyalinization of the vascular wall.Pathological examinations of all 3 patients suggested intestinal necrosis with fistulas.CONCLUSION:Intestinal necrosis is strongly associated with stress from trauma and post-traumatic complications; timely exploratory laparotomy maybe an effective method for preventing and treating stressinduced intestinal necrosis.
Intestinal necrosisStressTraumaEarthquakeExploratory laparotomyFatty acid binding protein
Jia-Qing Gong、Guo-Hu Zhang、Fu-Zhou Tian、Yong-Hua Wang、Lin Zhang、Yong-Kuan Cao、Pei-Hong Wang
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Department of General Surgery, the People's Liberation Army General Hospital of Chengdu Command, Chengdu 610083, Sichuan Province, China
Fund of the People's Liberation Army General Hospital of Chengdu Command
NETL
NSTL
万方数据
维普
