Görg C, Schwerk W B
Department of Medicine, Philipps University, School of Medicine, Marburg, FRG.
Bildgebung. 1991;58(4):199-204.
We report on sonographic findings in 30 patients with traumatic (n = 13) or non-traumatic (n = 17) splenic injury. An ultrasound (US)-based injury-severity-score consisting of three grades was devised and retrospectively applied in all patients. Initial sonographic abnormalities included: Intraperitoneal fluid (n = 10), perisplenic fluid (subcapsular hematoma) (n = 13), intrasplenic fluid (n = 10), splenic lacerations (n = 7) and intrasplenic flow phenomena diagnosed via Doppler-Ultra-sound (n = 3). The final diagnoses were splenic injury due to acute blunt traumatic episode (n = 9), chronic traumatic episode (n = 2), infectious mononucleosis (n = 2), splenic infarction (n = 14), and various causes (n = 3). On the basis of both imaging information and clinical factors, splenectomy was performed in 16 out of 30 patients. Five (31%) of these 16 patients were initially treated non-surgically but US findings during follow-up examinations made splenectomy necessary. Our results have shown that US remains a useful technique in identifying and quantifying initial splenic injury as well as monitoring the healing progress. Final treatment choices depend furthermore on clinical and laboratory assessments.
我们报告了30例创伤性（n = 13）或非创伤性（n = 17）脾损伤患者的超声检查结果。设计了一种基于超声（US）的由三个等级组成的损伤严重程度评分，并对所有患者进行回顾性应用。初始超声异常包括：腹腔内积液（n = 10）、脾周积液（包膜下血肿）（n = 13）、脾内积液（n = 10）、脾裂伤（n = 7）以及通过多普勒超声诊断的脾内血流现象（n = 3）。最终诊断为急性钝性创伤性发作导致的脾损伤（n = 9）、慢性创伤性发作（n = 2）、传染性单核细胞增多症（n = 2）、脾梗死（n = 14）以及各种原因（n = 3）。基于影像学信息和临床因素，30例患者中有16例接受了脾切除术。这16例患者中有5例（31%）最初接受非手术治疗，但随访检查期间的超声检查结果表明有必要进行脾切除术。我们的结果表明，超声在识别和量化初始脾损伤以及监测愈合进展方面仍然是一种有用的技术。最终的治疗选择还取决于临床和实验室评估。
