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创伤合并严重腹腔间隔室综合征患者急诊经皮导管引流术前、后CT图像对比的病例报告:一种识别出血源的宝贵工具

A Case Report of Contrasting Pre- and Post-Emergency Percutaneous Catheter Drainage CT Images in Patients Having Trauma with Severe Abdominal Compartment Syndrome: A Valuable Tool for Identifying Hemorrhage Sources.

作者信息

Im Jee Yea, Seo Sang Hyun

出版信息

J Korean Soc Radiol. 2025 Mar;86(2):284-290. doi: 10.3348/jksr.2024.0071. Epub 2025 Jan 2.

DOI:10.3348/jksr.2024.0071
PMID:40201607
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11973108/
Abstract

Abdominal compartment syndrome (ACS) is a life-threatening condition that rarely occurs in patients with severe abdominal trauma. Increased intra-abdominal pressure, often owing to hemoperitoneum, can reduce the mesenteric blood flow, making it challenging to evaluate the bleeding focus in multi-detector CT. Herein, we report a case of severe ACS after abdominal trauma. The initial CT scan showed hemoperitoneum but the source of active bleeding could not be identified. Percutaneous catheter drainage (PCD) was promptly performed to reduce the intra-abdominal pressure. Additional CT scans confirmed the bleeding source to be the superior mesenteric vein. The patient presented CT findings of primary ACS, and we evaluated the pre- and post-ACS imaging changes after PCD on abdominal CT. Accurate and timely recognition of the characteristic CT signs of ACS and shock bowel as well as precise interventional treatment are important skills for radiologists, particularly in cases of severe trauma and hypovolemia.

摘要

腹腔间隔室综合征(ACS)是一种危及生命的疾病,很少发生在严重腹部创伤患者中。腹腔内压力升高,通常由于腹腔积血所致,可减少肠系膜血流,这使得在多排CT上评估出血部位具有挑战性。在此,我们报告一例腹部创伤后严重ACS病例。初始CT扫描显示腹腔积血,但无法确定活动性出血的来源。立即进行经皮导管引流(PCD)以降低腹腔内压力。额外的CT扫描证实出血源为肠系膜上静脉。该患者呈现原发性ACS的CT表现,我们在腹部CT上评估了PCD前后ACS的影像学变化。准确及时地识别ACS和休克肠的特征性CT征象以及精确的介入治疗是放射科医生的重要技能,尤其是在严重创伤和低血容量的情况下。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0fe3/11973108/8342c3bac9ee/jksr-86-284-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0fe3/11973108/8342c3bac9ee/jksr-86-284-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0fe3/11973108/8342c3bac9ee/jksr-86-284-g001.jpg

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本文引用的文献

1
Abdominal compartment syndrome in trauma patients: New insights for predicting outcomes.创伤患者的腹腔间隔室综合征:预测预后的新见解。
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Successful interventional management of abdominal compartment syndrome caused by blunt liver injury with hemorrhagic diathesis.成功介入治疗伴出血倾向的钝性肝损伤致腹间隔室综合征
World J Emerg Surg. 2014 Mar 22;9(1):20. doi: 10.1186/1749-7922-9-20.
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