Author/Editor		Ivanecz, Arpad; Koželj, Miran; Borovšak, Zvonko; Pivec, Gregor; Potrč, Stojan; Brvar, Mirjana
Title		Perforacija debelega črevesa zaradi tope poškodbe trebuha s prikazom dveh primerov
Translated title		Perforation of the colon as a result of blunt abdominal trauma: a case reports
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 71, št. 6
Publication year		2002
Volume		str. 367-73
Language		slo
Abstract		Background. Blunt trauma to the abdomen is more likely to damage solid organs. Blunt injuries to the colon are uncommon and usually they follows a direct blow to the abdomen. Physical findings suggesting peritoneal iritation can be present early in the postinjury period but there is usually a delay in the manifestation of colonic injury. If the colonic perforation is present as a solitary injury, signs of peritoneal iritation are easier to recognize and they lead to further evaluation and operation. Because of theforce required to injure the colon, associated injuries often coexist, consequently physical findings may be masked, diagnosis delayed, and outcome compromised. Conclusions. Additionaly, the recent trend for conservative management of blunt abdominal trauma may lead to delay in diagnosis. Perioperative antibiotics and early laparotomy with complete intra-abdominal exploration and primary repair of the colon injury usually provide excellent results.
Summary		Izhodišča. Pri topi poškodbi trebuha obstaja večja verjetnost poškodbe parenhimskih organov. Tope poškodbe debelega črevesa so redke in nastanejo pretežno zaradi neposrednega udarca v trebuh. Fizikalni pregled lahko odkrije znake peritonealnega draženja, ki so lahko prisotni že kmalu po poškodbi, po navadi pa se znaki poškodbe debelega črevesa pojavijo s časovnim zamikom. Če je perforacija debelega črevesa prisotna kot edina poškodba, je znake peritonealnega draženja lažje prepoznati in vodijo k nadaljnjemu opredeljevanju in odločitvi za operacijo. Zaradi sile, ki je potrebna za poškodbo debelega črevesa, so pogoste pridružene poškodbe, ki lahko zakrivajo fizikalne znake, posledica česar je pozno postavljena diagnoza in s tem ogrožen izid. Zaključki. Sodobna načela konzervativnega zdravljenja topih poškodb trebuha pa lahko še dodatno pripomorejo k poznernu razpoznavanju. Antibiotiki in zgodnja odločitev za laparotomijo s celotnim pregledom trebušne votline in primarno oskrbo poškodbe debelega črevesa dajejo po navadi odlične rezultate.
Descriptors		ABDOMINAL INJURIES WOUNDS, NONPENETRATING COLON INTESTINAL PERFORATION TOMOGRAPHY, X-RAY COMPUTED