Wolff H, Lippert H
Klinik für Chirurgie, Humboldt-Universität zu Berlin.
Zentralbl Chir. 1988;113(1):1-19.
Serious intraabdominal injury due to intraabdominal hemorrhage, gastro-intestinal laceration with peritonitis or incarceration of abdominal organs. The most important question in the management is to ascertain a laparotomy or the diagnostic of a specific organ injury is needed. The peritoneal lavage is a great help in making this decision. The x-ray examinations of thorax, abdomen and bones are required. Adjunctive diagnostic modalities for subtile examination of organs are ultrasound, computed tomography and angiography. These examinations have a limited application. Exploratory laparotomy should be done if there are signs of peritoneal irritation with an increased tendency. 168 patients with blunt abdominal trauma where treated in Charity-hospital of Berlin. The laparotomy was necessary in 78 patients. In 70 cases we found organ injuries. It was pointed to splenic repair, the management of liver injury especially the packing of the laceration and the treatment of the injuries of gastro-intestinal tract, pancreas- and diaphragmatic rupture.
腹腔内出血、伴有腹膜炎的胃肠道撕裂或腹腔脏器嵌顿导致的严重腹腔内损伤。治疗中最重要的问题是确定是否需要进行剖腹手术或诊断特定器官损伤。腹腔灌洗对做出这一决定有很大帮助。需要进行胸部、腹部和骨骼的X线检查。用于精细检查器官的辅助诊断方法有超声、计算机断层扫描和血管造影。这些检查的应用有限。如果有腹膜刺激征且有加重趋势,应进行剖腹探查。柏林慈善医院治疗了168例钝性腹部创伤患者。78例患者需要进行剖腹手术。在70例中我们发现了器官损伤。指出了脾修补、肝损伤的处理,特别是裂伤的填塞以及胃肠道、胰腺和膈肌破裂损伤的治疗。