Department of Surgery, University of Connecticut, Hartford, CT, USA.
Am J Surg. 2013 Apr;205(4):414-8. doi: 10.1016/j.amjsurg.2012.12.003. Epub 2013 Jan 31.
Blunt hollow viscus injury (BHVI) is challenging to diagnose. The purpose of this study was to determine the reliability of physical exam and the role of computed tomography (CT) in the diagnosis of BHVI.
All blunt abdominal trauma (BAT) admissions to a level 1 trauma center from January 2009 through December 2011 were identified through the trauma registry. Data collected included demographics and findings on CT and physical exam.
Of 2,912 patients with blunt trauma, 340 had BAT, and 30 (9%) had BHVIs. The sensitivity and specificity of CT were 86% and 88%, respectively, whereas the sensitivity and specificity of clinical exam were 53% and 69%. Twenty-seven percent of patients with BAT and bladder injuries had concomitant BHVIs.
This is the largest single series of BHVI after BAT. CT is superior to clinical exam in establishing the diagnosis of BHVI. Although associated injuries are common, bladder injury may be an important marker for BHVI.
钝性中空内脏损伤 (BHVI) 的诊断具有挑战性。本研究旨在确定体格检查的可靠性和计算机断层扫描 (CT) 在 BHVI 诊断中的作用。
通过创伤登记处确定 2009 年 1 月至 2011 年 12 月期间所有到一级创伤中心就诊的钝性腹部创伤 (BAT) 患者。收集的数据包括人口统计学资料以及 CT 和体格检查的结果。
在 2912 例钝性创伤患者中，有 340 例 BAT，30 例 (9%) 有 BHVI。CT 的敏感性和特异性分别为 86%和 88%，而临床检查的敏感性和特异性分别为 53%和 69%。27%的 BAT 和膀胱损伤患者伴有 BHVI。
这是 BAT 后 BHVI 的最大单一系列研究。CT 在确立 BHVI 的诊断方面优于临床检查。尽管合并损伤很常见，但膀胱损伤可能是 BHVI 的一个重要标志物。
