Case Report of Injury in Rectum-Sigmoid Region in a Fifteen-Year Boy


Authors: J. Schwarz 1;  K. Siala 1;  M. Huml 1;  J. Sýkora 1;  J. Geiger 2;  V. Vacek 2;  J. Koželuhová 3;  R. Vondráková 4;  V. Lád 1;  J. Kobr 1
Authors‘ workplace: Dětská klinika FN a UK LF, Plzeň přednosta doc. MUDr. J. Kobr, Ph. D. 1;  Chirurgická klinika FN a UK LF, Plzeň přednosta prof. MUDr. V. Třeška, DrSc. 2;  I. interní klinika FN a UK LF, Plzeň přednosta doc. MUDr. M. Matějovič, Ph. D. 3;  Radiodiagnostická klinika FN a UK LF Plzeň přednosta doc. MUDr. B. Kreuzberg, CSc. 4
Published in: Čes-slov Pediat 2008; 63 (11): 620-625.
Category: Case Report

Overview

The report describes the case of a fifteen-year boy who allowed his naked gluteal region to be splashed by water fire extinguisher. A non-perforating barotrauma of the intestine and chemical irritation of the mucosa the fire-extinguishing mixture was the cause of chemical proctitis with developing complicating stenosis.

The period of the first four weeks after the insult the patient was treated at the regional surgery ward with the administration of local anti-inflammatory agents (mesalazin supp.). The outpatient endoscopic examination revealed a narrow stenosis of rectosigmoid region and the patient was therefore admitted at the Children Clinic of Faculty Hospital at Plzeň (Pilsen). The inquiry at the Toxicological Information Center made it clear that the content of water-based fire extinguishing mixtures includes potash and mixture has alkaline pH (11) with caustic properties. A systemic complex therapy followed (parenteral nutrition, corticoids, antibiotics, mesalazin), which results in completed healing without requirement of surgical intervention.

The authors discuss Pathophysiological mechanisms, diagnostic and therapeutic procedures and recommend that consensus of therapeutic approach to patients with severe caustic injuries of colon are established.

Key words:
caustic injury, barotraumas, caustic, fire-extinguisher, rectosigmoid, children, diagnostics, therapy


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Labels
Neonatology Paediatrics General practitioner for children and adolescents
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