直腸損傷を伴った開放性骨盤骨折の1例

• Published in: Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) Vol. 36; no. 1; pp. 173 - 176
• Main Authors: 村田, 厚夫, 古城, 都, 三宅, 亮, 西中, 徳治, 中沼, 寛明
• Format: Journal Article
• Language: Japanese
• Published: 日本腹部救急医学会 2016; Japanese Society for Abdominal Emergency Medicine
• Subjects: ダメージコントロール; 直腸用カテーテル; 開放性骨盤骨折
• ISSN: 1340-2242; 1882-4781
• DOI: 10.11231/jaem.36.173

It is well known that a severe pelvic fracture with perineal injury might be complicated by various infections, especially occurring in perineal areas, following critical sepsis. We have saved a patient suffering from an open-book type pelvic fracture with rectal injury and broad perineal laceration, traumatic brain injury, and chest trauma, as we performed damage control strategy. In particular, we used a commercially available anal catheter as a fecal diversion for the prevention of perineal infection. We suggest that this catheter diversion method is very easy as well as highly effective for the prevention of perineal infection after severe pelvic trauma. 開放性骨盤骨折は出血や骨盤内深部感染症を引き起こし，高い死亡率を示す重症外傷の一つである。われわれは，墜落外傷による他臓器損傷と出血性ショックを伴った開放性骨盤骨折に対し，ダメージコントロール手術を実施し，fecal diversionとして人工肛門造設と直腸用カテーテルを併用し深部感染予防に対処し救命し得た1例を経験したので報告する。