Richard Ray is Head Athletic Trainer and Associate Professor of Kinesiology at Hope College, Holland, MI 49423.
J Athl Train. 1995 Oct;30(4):324-6.
Serious abdominal injuries in athletics, including liver trauma, are relatively rare. When they do occur, the athletic trainer and the team physician must be able to recognize the signs and symptoms and employ the appropriate first aid and follow-up care. In this paper, we present a case study of a football player who suffered a lacerated liver as a result of a forceful blow to the right side of the chest. Although his case was typical of most isolated liver injuries and he did not experience massive internal bleeding, the potential for life-threatening exsanguination exists and must be recognized by by sports health care practitioners. Most isolated liver injuries can be treated nonsurgically. However, those patients with multiple organ trauma, deteriorating vital signs, or diminishing hemodynamic stability generally require immediate surgery. Athletes with persistent right upper quadrant pain, especially when accompanied by referred pain to the right shoulder, abdominal rigidity, guarding, or rebound pain should be considered to have a liver injury until ruled out by CT scan and liver enzyme studies. Our subject was typical of most athletic liver patients and he was able to resume light exercise after 5 weeks and full activity after 3 months.
体育运动中严重的腹部损伤,包括肝脏创伤,相对较少见。当它们确实发生时,运动训练师和队医必须能够识别出迹象和症状,并采用适当的急救和后续护理。在本文中,我们介绍了一名足球运动员的病例,他因右侧胸部受到强烈冲击而导致肝脏裂伤。尽管他的情况是大多数孤立性肝损伤的典型表现,且没有发生大量内出血,但仍存在危及生命的失血性休克的可能性,这必须得到运动保健医生的认识。大多数孤立性肝损伤可以非手术治疗。然而,那些有多个器官创伤、生命体征恶化或血流动力学稳定性降低的患者通常需要立即手术。持续性右上腹疼痛的运动员,特别是伴有右肩牵涉痛、腹部强直、压痛或反跳痛的运动员,应考虑有肝脏损伤,直到 CT 扫描和肝酶研究排除肝脏损伤。我们的研究对象是大多数运动性肝损伤患者的典型代表,他在 5 周后能够恢复轻度运动,3 个月后能够恢复完全运动。