Small mesentery injury

Introduction to small mesenteric injury The small intestine and its mesentery account for a large volume in the abdominal cavity, wide distribution, lack of strong protection, and are susceptible to injury, accounting for about 1/4 of abdominal organ injuries, and the first place in the abdominal organs during wartime. The blunt injury is caused by the violent compression of the small intestine into the lumbar vertebral body. The contents of the extruded intestine are rapidly moved up and down, up to the ligament of the flexor, and down to the ileocecal valve to form a high-pressure closed intestinal segment. The perforation is mostly in the upper and lower 70cm range of the small intestine, occasionally due to indirect violence (high drop, rapid sudden pause in rapid travel), due to inertia, the intestinal tube vibrates violently in the abdominal cavity, and the gas and liquid in the intestinal tube are suddenly transmitted to a certain intestine. Hey, the pressure in the cavity increases suddenly, causing the intestine to rupture. A few are caused by excessive contraction of the abdominal muscles or iatrogenic causes. basic knowledge The proportion of illness: 0.005% Susceptible people: no specific population Mode of infection: non-infectious Complications: peritonitis shock

Cause of small mesenteric injury

The blunt injury is caused by the violent compression of the small intestine into the lumbar vertebral body. The contents of the extruded intestine are rapidly moved up and down, up to the ligament of the flexor, down to the ileocecal valve, forming a high-pressure closed intestinal segment, and the perforation is mostly in the small intestine. In the lower 70cm range, occasionally due to indirect violence (high drop, rapid sudden pause in rapid travel), due to inertia, the intestinal tube vibrates violently in the abdominal cavity, and the gas and liquid in the intestinal tube are suddenly transmitted to a certain intestinal fistula. Sudden increase, causing rupture of the intestine, a small number due to excessive contraction of the abdominal muscles or iatrogenic causes.

Small mesenteric injury prevention

The mortality of small intestine injury depends on whether the operation is timely and whether there is a combined organ injury. According to the literature, the operation within 12 hours after the injury, the mortality rate is 7.3%, the operation after 12 hours after the injury, the mortality rate is as high as 27.3%, simple The mortality of small intestine injury is below 5%. With the increase of combined organ injury, the mortality rate rises sharply.

Complications of small mesenteric injury Complications peritonitis shock

Complications such as peritonitis, shock and poisoning may occur.

Symptoms of small mesenteric injury Common symptoms Abdominal tenderness Peritonitis Small intestine injury Lower abdominal pain Hemorrhagic shock

The clinical manifestations of small intestine injury mainly depend on the degree of injury and the presence or absence of organ injury. The main manifestations are peritonitis. Shock and poisoning may not be obvious. Some patients may present with internal hemorrhage, especially in hemorrhagic shock.

Examination of small mesenteric injury

Abdominal X-ray examination is of limited value, and only a few cases can see free gas under the arm.

Abdominal puncture can provide strong evidence.

CT, MRI examination can help diagnose.

Diagnosis and differential diagnosis of small mesenteric injury

Diagnostic abdominal puncture can get digestive juice or bloody liquid, no difficulty in diagnosis, abdominal X-ray examination is limited in value, only a few cases can see free gas under the armpit, some small intestine blunt injury, early (within 6 hours after injury) often no obvious Symptoms and signs, difficult to diagnose, should be closely observed, abdominal puncture can provide strong evidence.

It is differentiated from gastric damage, spleen damage, liver damage, and kidney damage.

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