Hager Anders M, Kløw Nils-Einar, Gaarder Christine, Naess Pål Aksel, Dormagen Johann Baptist
Radiologisk avdeling, Sykehuset i Vestfold, 3103 Tønsberg.
Tidsskr Nor Laegeforen. 2005 May 19;125(10):1336-7.
Blunt splenic injuries are increasingly being managed non-operatively. Consequently, radiological examinations in the follow up of these injuries must aim at detecting lesions like pseudoaneurysms that can cause delayed bleeding. Two patients are presented. They were both diagnosed at a local hospital and treated at the regional trauma centre. In both patients pseudoaneurysms were detected on CT examination with arterial contrast phase. Angiographic embolisation was performed successfully. The cases are discussed with reference to relevant literature. Pseudoaneurysms may not be detected at the initial CT scan and can cause delayed bleeding. Thus it seems wise to perform a CT scan in arterial and venous contrast phase 5-7 days after the injury. Interventional angiography should be offered haemodynamically stable adult patients with serious splenic injury and in the absence of other indications for laparotomy.
钝性脾损伤越来越多地采用非手术治疗。因此，这些损伤随访中的影像学检查必须旨在检测可能导致延迟出血的病变，如假性动脉瘤。本文介绍了两名患者。他们均在当地医院确诊，并在区域创伤中心接受治疗。两名患者在CT动脉造影期检查中均发现假性动脉瘤。成功进行了血管造影栓塞术。结合相关文献对病例进行了讨论。假性动脉瘤在初次CT扫描时可能未被发现，并可能导致延迟出血。因此，在受伤后5 - 7天进行动脉期和静脉期CT扫描似乎是明智的。对于血流动力学稳定、有严重脾损伤且无其他剖腹手术指征的成年患者，应提供介入性血管造影。
