McLaughlan C A, Maheson M, Sloan J P, Dove F
University Hospital, Nottingham, England.
Arch Emerg Med. 1988 Mar;5(1):34-7. doi: 10.1136/emj.5.1.34.
A series of patients who were found at operation to have sustained splenic rupture is described and their immediate presenting features are detailed. Signs of peritoneal irritation were not always present and patients were not often 'shocked' when first seen. Helpful early signs included a low haemoglobin and pallor. There is a tendency to underestimate the significance of left quadrant pain in the presence of rib fractures. Peritoneal lavage and ultrasound should be more readily employed. Text book features should not be expected early and this must be taught to junior doctors who work in accident and emergency medicine.
本文描述了一系列在手术中发现患有脾脏破裂的患者，并详细介绍了他们最初的临床表现。腹膜刺激征并非总是存在，患者初次就诊时也不常出现“休克”症状。早期有用的体征包括血红蛋白降低和面色苍白。在存在肋骨骨折的情况下，往往会低估左下腹疼痛的重要性。应更积极地采用腹腔灌洗和超声检查。早期不应期望出现典型症状，这一点必须向从事急诊医学的初级医生传授。
