Traumaticfistulaofsmallintestine
外伤性小肠瘘
ZhizhaoJiang,YuexiangSu,YuqiLiu.DepartmentofIntensiveCareUnitofthesecondaffiliatedhospitalofFujianMedicalUniversity.
Description病史简介
A63-year-oldmanexperiencedabdominaltrauma,drainagetubedrainageoftheyellowliquidforonemonthafteroperation,nonhypertensive,nondiabetic,nohistoryoftuberculosis.
63岁男性，腹部外伤术后引流管引流出*色液体1月，无高血压、糖尿病、结核病史。
SinusTractRadiography窦道造影
Legends图例
Thecontrastagentsshadowpuaminewasinjectedintothelowerabdominalfistula,andthenwecanseethesmallintestinaldevelopment,butdidnotseetheunusualcontrastagentsaroundtogether.
经下腹部窦道注入造影剂泛影蒲胺，见小肠显影，周围未见异常造影剂浓聚。
MainTreatmentpoints主要治疗要点
lContinuingflushanddrainagebydoublecatheterizationcannula
双套管持续冲洗引流
lSomatostatininhibitingthesecretionofdigestivejuices
生长抑素抑制消化液分泌
lNutritionsupport（parenteralandenternal）
营养支持（肠外+肠内）；造影见窦道已成熟，故行肠内营养，“边吃边瘘”
lFibringlueplugabdominalwallfistula
纤维蛋白胶封堵
AfterSevenWeeksOfTreatment治疗7周后复查
Legends图例
Aftersevenweeksoftherapy,thepatientwascheckedagain,andthenwecanseeabdominalsinglefistulaformation,butdidnotseesmallintestineenhancementandpuscavityformation.
经过7周的治疗后，再次复查，见腹腔单窦道形成，未见小肠显影及脓腔形成。
Traumaticfistulaofsmallintestine
外伤性小肠瘘
Background背景
Theintestinesandstomachhaveabnormalchannelwithothercavityvisceraoutside、insideoroutsidebodycavity,intestinalcontentswillfollowthispathandenterotherbodycavityorvitro;itoftencausedbyabdominalsurgery、traumaorinflammatoryboweldisease.
指肠胃与其他空腔脏器、体腔或体腔外有异常的通道，肠内容物将循此进入其他脏、体腔或体外；多由腹部手术、外伤、炎症性肠病所致。
ClinicalInformation临床特征
Itmaincauseinfection、fluidloss、unbalanceofhomeostasis、damageoforganfunctionandsoon.
主要引起感染、体液丧失、内部稳态失衡、器官功能受损、心脏营养不良等改变。
KeyDiagnosticFeature诊断要点
lNatureoftheleakingfluid
漏出液的性质
lTheeversionofintestinalmucosalmembrane
肠粘膜外翻
lMeasuringtheamylaseconcentrationofdrainageliquid
测引流液的淀粉酶的浓度
lOralindicator,suchasmethyleneblue
口服美蓝等指示剂
lFistulaangiographyimagingexamination,etc
窦道造影等影像学检查
Treatment治疗
lCorrecthomeostasisunbalance
纠正内稳态失衡
lControlofinfection
控制感染
lStrengthenthemanagementofthefistula
加强瘘口的管理
lPayattentiontonutritionalsupport
重视营养支持
lMaintainthefunctionofthevitalorgans
维护重要器官的功能
lThepreventionandtreatmentof北京看白癜风什么医院好皮肤病治疗医院哪家好