摘要
一名54歲男子使用鐵撬在修繕屋頂時，不慎失足下墜地面，右腹遭同時緊隨脫手掉落的鐵撬所貫穿，且鐵撬尖端從其左臀突出，他採坐姿方式送院治療。緊急剖腹探查結果發現，鐵撬自右肋下緣插入，沒有觸及肝膽和大血管，僅貫穿部分近端空腸和乙狀直腸，在安全無虞下小心拔除貫穿體腔的鐵撬，並修補傷裂空腸，乙狀結腸則清創後，以結腸造口作減壓和排泄，病患術後復元良好，沒有發生腹腔感染情形。受傷三月後，接受處次手術原閉結腸造口，門診追蹤二年，骨腸功能正常。我們報告是例，重點是其受傷過程和異物橫貫腹腔皆較少見，急診處置和麻醉誘導完全採用坐姿中進行，在一般急診手術作業也是特殊個案，透過團隊合作成功治療是例。
關鍵字
無資料並列摘要
An unusual case of an abdominal penetrating injury by a chisel is presented. A 54-year-old man who was working as a carpenter fell from a 10m-high-asbestos foof. He suffered impalement through the right upper quadrant of the abdomen to the left buttock while falling. He was brought to the emergency room and sent surgaery. The chisel was removed after exploration for organ and great vessel injuries. The patient was discharged from hospital with temporary colostomy on the 15th day after the accident. Closure of the colostomy was done three months after the first operation.
延伸閱讀
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