Vichard P, Dreyfus-Schmidt G, Weill F, Rohmer P
Ann Gastroenterol Hepatol (Paris). 1986 Oct;22(5):277-81.
Classically, the diagnosis of hemoperitoneum is based on clinical symptoms, which are not always relevant. Several complementary procedures can be considered when dealing with polytraumatic patients who may be comatose: scintigraphy, arteriography, CT, sonography and peritoneal lavage. The authors have finally selected sonography and lavage. Since ultrasound is reliable, reproductable and non aggressive, it is being more and more utilized. It readily shows solid-liquid contrast, and is particularly sensitive in displaying fluid in peritoneal recesses; parenchymal lesions are also evaluated. II enables one to explore the abdominal cavity with precision. Lavage is reserved for acute lesion with severe, evolutive hemoperitoneum, requiring immediate surgery. The indications for other imaging modalities are also discussed.
传统上，腹腔积血的诊断基于临床症状，但这些症状并非总是具有相关性。在处理可能昏迷的多发伤患者时，可以考虑几种辅助检查方法：闪烁扫描、动脉造影、CT、超声检查和腹腔灌洗。作者最终选择了超声检查和灌洗。由于超声检查可靠、可重复且无创，其应用越来越广泛。它能清晰显示固体-液体对比，在显示腹膜隐窝内的液体方面特别敏感；还可评估实质脏器病变。它能精确地探查腹腔。灌洗则适用于伴有严重、进行性腹腔积血的急性病变，需要立即进行手术。本文还讨论了其他成像方式的适应证。
