2009, Number 3
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Cir Gen 2009; 31 (3)
Sigmoid colon perforation due to blunt trauma. Management with hand-assisted laparoscopic surgery
Terrazas EF, Mancera SC, Galindo NA
Language: Spanish
References: 38
Page: 186-191
PDF size: 122.24 Kb.
ABSTRACT
Objective: To present an infrequent case of sigmoid colon rupture due to blunt abdominal trauma and its management with hand-assisted laparoscopic surgery.
Setting: Third level health care hospital.
Design: Case report and review of the literature.
Description of the case: Male patient, 52 years old, who sufferred a blunt abdominal trauma 10 days before being admitted in the emergency service of our institution. He referred difuse abdominal pain, with a left-sided hematoma reaching the iliac fossa, without leukocytosis, with 87% neutrophiles. CAT scan was performed and revealed free air in the abdominal cavity and a purulent collection around the sigmoid colon. He was subjected to hand-assisted laparosocopy, finding perforation of the sigmoid and a pericolon abscess. The perforated sigmoid was resected, and a Hartmann procedure with colostomy was performed. The patient evolved satisfactorily, and was discharged on the 5th day. Intestinal transit was restituted by end-to-end anastomosis by means of hand-assisted laparoscopy after 11 weeks. He evolved satisfactorily and was discharged on the 5th post-operative day.
Conclusions: Hand-assisted laparoscopy can be useful and satisfactory to manage perforated injuries of the colon caused by blunt abdominal trauma. This resource must be further evaluated in comparative prospective studies.
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