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>Journals >Cirujano General >Year 2009, Issue 3


Terrazas EF, Mancera SC, Galindo NA
Sigmoid colon perforation due to blunt trauma. Management with hand-assisted laparoscopic surgery
Cir Gen 2009; 31 (3)

Language: Español
References: 38
Page: 186-191
PDF: 4. Kb.


Full text




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.


Key words: Hand assisted laparoscopic surgery, perforation, colon, large bowel, laparoscopy, Hartmann’s procedure, colostomy.


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