腹部鈍的外傷による胃破裂の1例

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  • RUPTURE OF THE STOMACH DUE TO A BLUNT ABDOMINAL TRAUMA-A CASE REPORT-

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Blunt abdominal trauma commonly affects the small intestine, and injury of the stomach rarely occurs. This paper presents a case of rupture of the stomach due to a blunt abdominal trauma.<br> A 62-year-old man injured in a traffic accident while he was driving his car about 2 hours after a supper. He buckled up his shoulder strap. When he was first seen at the hospital, abdominal pain was present, but no peritoneal signs nor abnormalities on an abdominal CT scan were revealed. Most severe pain was noted at the right thigh. He was admitted to the hospital with diagnoses of bruise to the head, contusion wound to the face, bruise to the chest and abdomen, and dislocation and fracture of the right hip joint. On the next day, abdominal pain mainly localized to the epigastrium lasted. There were Blumberg signs but no muscular defense was noted. Abdominal CT scan on the next day revealed intraabdominal free air. The patient was operated on with a diagnosis of rupture of the intestine. At laparotomy, rupture about 1cm in size was found at the sphincter posterior wall of the lesser curvature. No injured organs other than the stomach were demonstrated. The injured site was sutured and covered with greater omentum. Wound infection occurred after the operation but improved. The patient was transferred to the department of orthopedics in our hospital for the treatment of dislocation and fracture of the right hip joint.

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