Buckman R F, Piano G, Dunham C M, Soutter I, Ramzy A, Militello P R
Department of Surgery, MIEMSS, Baltimore.
J Trauma. 1988 Sep;28(9):1317-21. doi: 10.1097/00005373-198809000-00004.
The incidence of major bowel and diaphragm injuries occurring in association with blunt spleen and liver ruptures in adults was studied. Of 142 patients with splenic injuries, five had major bowel injuries and 12 had diaphragmatic ruptures. Of 102 patients with blunt hepatic injury, 13 had either bowel or diaphragm ruptures or both. Six bowel and diaphragm injuries occurred in 42 patients with blunt ruptures of both the liver and spleen. Anatomically minor spleen injuries were associated with a 4.8% risk of bowel or diaphragm rupture. Anatomically major splenic lacerations had associated bowel or diaphragm wounds in 16.4% of cases (p = 0.024). A 20% incidence of partial-thickness bowel wounds was found in patients with hepatic or splenic injury, but the natural history of these wounds is unknown.
对成人钝性脾破裂和肝破裂合并发生的主要肠和膈肌损伤的发生率进行了研究。在142例脾损伤患者中，5例有主要肠损伤，12例有膈肌破裂。在102例钝性肝损伤患者中，13例有肠或膈肌破裂或两者皆有。42例肝脾钝性破裂患者发生了6例肠和膈肌损伤。解剖学上轻微的脾损伤发生肠或膈肌破裂的风险为4.8%。解剖学上严重的脾裂伤在16.4%的病例中有相关的肠或膈肌伤口（p = 0.024）。在肝或脾损伤患者中发现20%的肠伤口为部分厚度，但这些伤口的自然病程尚不清楚。
