Farhat G A, Abdu R A, Vanek V W
Department of Surgery, St. Elizabeth Hospital Medical Center, Youngstown, Ohio 44501-1790.
Am Surg. 1992 Jun;58(6):340-5.
Although splenic injury is the most frequent abdominal injury resulting from blunt trauma, delayed splenic rupture is a rare event. From 1981 to 1990, 75 patients treated at St. Elizabeth Hospital Medical Center (Youngstown, OH) had blunt splenic injury. Splenic rupture was delayed in six of these patients (8%). More severe trauma, such as occurs with motor vehicle accidents, is more likely to lead to immediate rupture. Lesser trauma resulting from minor falls or fights is more likely to lead to delayed rupture. Subcapsular hematoma is the most common etiology for delayed splenic rupture. Although there is no reliable symptom or sign during the latent period, abdominal pain occurs almost uniformly and Kehr's sign is quite common. Peritoneal lavage and abdominal computerized axial tomography scan are accurate in diagnosing splenic rupture. Unfortunately, they are not always reliable in predicting delayed rupture.
尽管脾损伤是钝性创伤导致的最常见腹部损伤，但延迟性脾破裂是一种罕见情况。1981年至1990年期间，在圣伊丽莎白医院医疗中心（俄亥俄州扬斯敦）接受治疗的75例钝性脾损伤患者中，有6例（8%）发生了延迟性脾破裂。更严重的创伤，如机动车事故中发生的创伤，更有可能导致立即破裂。轻微跌倒或打架导致的较轻创伤更有可能导致延迟破裂。包膜下血肿是延迟性脾破裂最常见的病因。虽然在潜伏期没有可靠的症状或体征，但腹痛几乎普遍出现，凯尔氏征也相当常见。腹腔灌洗和腹部计算机轴向断层扫描在诊断脾破裂方面很准确。不幸的是，它们在预测延迟破裂方面并不总是可靠的。
