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因车把致伤的钝性腹部创伤。

Blunt abdominal trauma due to handlebar injury.

机构信息

Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

出版信息

Rev Chil Pediatr. 2020 Oct;91(5):754-760. doi: 10.32641/rchped.vi91i5.1568.

Abstract

INTRODUCTION

Bicycle accidents are a frequent cause of blunt abdominal trauma in children. In Chile, there are no scientific articles about such accidents, their presentation and management.

OBJECTIVE

The aim of this study is to describe three cases of blunt abdominal trauma due to handlebar injury in children, in order to illustrate the different kinds of lesions, their presentation, and management.

CLINICAL CASES

  1. 11-year-old boy presented to Emergency Department (ED) after falling on a bi cycle handlebar, hitting his epigastric region. A CT scan showed signs of duodenal perforation. A la parotomy was performed and the duodenal perforation repaired. 2) 14-year-old boy seen at ED after a bicycle accident in which the handlebar hit him in the abdomen area. A CT scan showed a splenic injury with multiple lacerations and active bleeding that was treated with angioembolization. After 6 weeks of follow-up, he presented resolution of the lesion and viability of the spleen. 3) 9-year-old boy admitted due to a hit with the bicycle handlebar on the abdomen area. A CT scan showed a he patic injury that was managed with non-surgical procedures, achieving resolution of the lesion after 8 weeks of follow-up.

CONCLUSION

Blunt abdominal trauma caused by handlebar can be potentially serious in pediatric patients, since it may affect solid and hollow abdominal viscera. Non-surgical ma nagement is becoming more used for stable patients, achieving high success rates. Unstable patients or those with suspicion of hollow viscera perforation will require surgery as first approach.

摘要

简介

自行车事故是儿童腹部钝挫伤的常见原因。在智利,没有关于此类事故、表现和处理的科学文章。

目的

本研究旨在描述 3 例因车把受伤导致的儿童腹部钝挫伤病例,以说明不同类型的损伤、表现和处理。

临床病例

1)11 岁男孩在骑自行车时摔倒,车把击中上腹部,到急诊科就诊。CT 扫描显示十二指肠穿孔的迹象。行剖腹术并修复十二指肠穿孔。2)14 岁男孩因自行车事故到急诊科就诊,车把击中腹部。CT 扫描显示脾损伤,多处撕裂,活动性出血,采用血管栓塞治疗。6 周随访后,病变和脾活力均得到缓解。3)9 岁男孩因腹部被自行车车把撞击而住院。CT 扫描显示肝脏损伤,采用非手术治疗,8 周随访后病变得到缓解。

结论

自行车车把引起的腹部钝挫伤在儿科患者中可能较为严重,因为它可能影响腹部实质和空腔内脏器。对于稳定的患者,非手术治疗的应用越来越多,成功率较高。不稳定的患者或怀疑空腔内脏器穿孔的患者将需要手术作为首选方法。

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