Coleman Jamie J, Zarzaur Ben L
Department of Surgery, Indiana University School of Medicine, 1604 North Capitol Avenue, Office B242, Indianapolis, IN 46202, USA.
Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
Surg Clin North Am. 2017 Oct;97(5):1107-1117. doi: 10.1016/j.suc.2017.06.004.
Hollow viscus injury is common with penetrating trauma to the torso and infrequent with a blunt traumatic mechanism of injury. The diagnosis in hemodynamically unstable patients is often made in the operating room. In hemodynamically stable patients, the diagnosis can be difficult due to additional injuries. Although computed tomography remains the diagnostic tool of choice in hemodynamically stable patients, it has lower reported sensitivity and specificity with hollow viscus injury. However, even short delays in diagnosis increase morbidity and mortality significantly. Operative management of stomach, duodenal, small bowel, and colon injuries is reviewed.
中空脏器损伤在躯干穿透性创伤中很常见,而在钝性创伤机制中则不常见。血流动力学不稳定患者的诊断通常在手术室进行。对于血流动力学稳定的患者,由于存在其他损伤,诊断可能会很困难。尽管计算机断层扫描仍是血流动力学稳定患者的首选诊断工具,但据报道其对中空脏器损伤的敏感性和特异性较低。然而,即使诊断稍有延迟也会显著增加发病率和死亡率。本文综述了胃、十二指肠、小肠和结肠损伤的手术治疗。