colorectal injury
Introduction
Introduction to colorectal injury Colonic rectal injury is usually caused by industrial and agricultural production trauma, traffic accidents, life accidents and fighting. It is more common in closed abdominal injury. The incidence is lower in the abdominal visceral injury than in the small intestine, spleen, liver and kidney. 5th place. basic knowledge Probability ratio: 10% of specific population Susceptible people: no specific population Mode of infection: non-infectious Complications: peritonitis, shock, retroperitoneal infection and abscess
Cause
Causes of colorectal injury
1, blunt injury to the abdomen suffered heavy objects, such as work-related injuries, car accidents, falling, falling, fighting, boxing and other blunt violent blows, the large intestine is located between the posterior abdominal wall and the anterior abdominal impact force, causing injury to the intestinal wall, perforation or fracture.
2, knife stab wounds are seen in bayonet wounds, usually seen in fighting, murder, robbery and other public security accidents.
3, firearms warfare shrapnel, gunshot wounds, often combined with small intestine or abdominal cavity, other organs of the body damage.
4, iatrogenic injury sigmoidoscopy, colonic perforation caused by colonic perforation, is not uncommon.
Prevention
Colorectal injury prevention
In the case of abdominal trauma, the colonic rectal injury is guarded, and early treatment is found early to prevent complications.
Complication
Complications of colorectal injury Complications Peritonitis shock retroperitoneal infection and abscess
1. Bacterial peritonitis.
2. Toxic shock.
3. Retroperitoneal infection.
Symptom
Symptoms of colorectal injury Common symptoms Intestinal perforation, bowel, peritoneal irritation, tension, peritonitis, abdominal tenderness, abdominal pain
1. History of trauma There is a history of trauma or history of colonoscopy in the abdomen or other nearby areas, and abdominal pain or other discomfort after the injury.
2, clinical manifestations
(1) Abdominal pain and vomiting: knot, rectal perforation or large blockage, abdominal cavity pain and vomiting after the feces in the intestinal cavity overflow into the abdominal cavity, the pain is first confined to the perforation, and then spread to the abdomen to form diffuse peritonitis, with a full abdomen pain.
(2) peritoneal irritation: abdominal tenderness, muscle tension and rebound tenderness, the most obvious pain in the perforation or rupture site.
(3) The bowel sounds weaken or even disappear.
(4) digital rectal examination: low rectal injury can touch the injury site with a hollow feeling, the finger is covered with blood, and only a few blood lesions in the colon injury.
Examine
Examination of colorectal injury
1, rectal examination.
2, blood routine examination of white blood cell count and neutrophilia.
3, X-ray photographs for closed injury, when the patient's condition allows standing photos, most of the free gas under the armpit can be found.
4, B-ultrasound, CT, MRI have the above examination can not be a clear diagnosis, you can selectively use any one of the two checks to help diagnose.
Diagnosis
Diagnosis and diagnosis of colorectal injury
diagnosis
Can be diagnosed based on clinical performance and laboratory tests.
1. Small intestine rupture.
2. Stomach, 12 rectal injury.
Differential diagnosis
1. Small intestine perforation caused by the action of various external forces in the small intestine is called small intestine rupture. Clinical manifestations include abdominal pain, bloating, and peritonitis, which may be associated with shock.
2. Signs of symptoms of stomach and duodenal injury are nausea, vomiting, blood in the stool, hematuria, and treatment and effect. Physical examination pay attention to blood pressure, pulse, breathing, and signs of shock.
