Smith Cassandra, Stephenson Graham, Wray Alisa, Hatter Matthew
University of California, Irvine, Department of Emergency Medicine, Orange, CA.
J Educ Teach Emerg Med. 2023 Jul 31;8(3):V5-V9. doi: 10.21980/J84D2Q. eCollection 2023 Jul.
The authors present the case of a 42-year-old male who was evaluated in a community hospital emergency department (ED) with right upper quadrant and flank pain after falling onto his couch. His evaluation included computed tomography (CT) of his abdomen with intravenous contrast that identified a large right retroperitoneal hematoma measuring an impressive 17 centimeters (cm) in length. The patient was transferred to a receiving trauma center. Upon arrival a focused assessment with sonography in trauma (FAST) ultrasound was obtained. The interpretation of the findings was complicated by distortion of his anatomy by the hematoma. The patient remained hemodynamically stable and was admitted for continued observation. He was ultimately discharged home in stable condition. This case report provides a concise overview of the approach to evaluating blunt abdominal trauma, imaging considerations, and a brief review of the management of retroperitoneal hematomas.
Trauma, retroperitoneal hemorrhage, ultrasound, FAST, computed tomography, hepatorenal recess, Morrison's pouch.
作者介绍了一名42岁男性的病例，该患者因摔倒在沙发上后出现右上腹和侧腹疼痛，在社区医院急诊科接受评估。他的检查包括腹部增强计算机断层扫描（CT），发现一个巨大的右侧腹膜后血肿，长度达17厘米，令人印象深刻。患者被转至一家接收创伤的中心。到达后，进行了创伤重点超声评估（FAST）。血肿对其解剖结构的扭曲使检查结果的解读变得复杂。患者血流动力学保持稳定，入院继续观察。他最终病情稳定出院。本病例报告简要概述了钝性腹部创伤的评估方法、影像学考量以及腹膜后血肿的治疗简述。
创伤、腹膜后出血、超声、FAST、计算机断层扫描、肝肾隐窝、莫里森陷窝
