Department of Radiology, University of Miami Leonard Miller School of Medicine, University of Miami Health System, Jackson Memorial Hospital, and Ryder Trauma Center, 1611 NW 12th Ave, West Wing 279, Miami, FL 33136, USA.
Radiographics. 2013 Mar-Apr;33(2):341-59. doi: 10.1148/rg.332125006.
Penetrating injuries account for a large percentage of visits to emergency departments and trauma centers worldwide. Emergency laparotomy is the accepted standard of care in patients with a penetrating torso injury who are not hemodynamically stable and have a clinical indication for exploratory laparotomy, such as evisceration or gastrointestinal bleeding. Continuous advances in technology have made computed tomography (CT) an indispensable tool in the evaluation of many patients who are hemodynamically stable, have no clinical indication for exploratory laparotomy, and are candidates for conservative treatment. Multidetector CT may depict the trajectory of a penetrating injury and help determine what type of intervention is necessary on the basis of findings such as active arterial extravasation and major vascular, hollow viscus, or diaphragmatic injuries. Because multidetector CT plays an increasing role in the evaluation of patients with penetrating wounds to the torso, the radiologists who interpret these studies should be familiar with the CT findings that mandate intervention.
穿透性损伤占全球急诊科和创伤中心就诊的很大比例。对于非血流动力学不稳定且具有剖腹探查临床指征（如内脏脱出或胃肠道出血）的穿透性躯干损伤患者，急诊剖腹手术是公认的标准治疗方法。技术的不断进步使得计算机断层扫描（CT）成为评估许多血流动力学稳定、无剖腹探查临床指征且适合保守治疗患者的不可或缺的工具。多排 CT 可以描绘穿透性损伤的轨迹，并根据动脉外渗和主要血管、中空内脏或横膈膜损伤等发现，帮助确定需要哪种干预类型。由于多排 CT 在评估躯干穿透性伤口患者中的作用越来越大，因此解读这些研究的放射科医生应该熟悉需要干预的 CT 发现。
