Kurtzman R S
Surg Clin North Am. 1977 Feb;57(1):211-26. doi: 10.1016/s0039-6109(16)41145-x.
Blunt abdominal trauma can produce injury to any of the intra-abdominal organs. While diagnostic studies may be necessary to help determine the most appropriate therapy, all these procedures take time, which in some instances can be better used to treat the patient actively. The condition of the patient and the clinical findings take precedence in the handling of the injured patient. Certain skeletal injuries are often a first clue and can help focus further investigations. Plain films and regular contrast examinations are adequate to evaluate most intra-abdominal injuries. When time is available, a variety of other radiologic techniques are available in most hospitals. Nuclear imaging is of considerable value in studying the liver, spleen, and kidneys. Thus far, ultrasound techniques have left much to be desired although theoretically of considerable potential. Angiography can be of great diagnostic and potentially of some therapeutic value. No diagnostic test beats a good history and careful examination. Radiologic studies, ideally, should be done to confirm a clinical suspicion, not just for the sake of "completeness."
钝性腹部创伤可导致腹内任何器官受损。虽然可能需要进行诊断性检查以帮助确定最合适的治疗方法,但所有这些检查都需要时间,在某些情况下,这些时间或许能更好地用于积极治疗患者。在处理受伤患者时,患者的状况和临床发现最为重要。某些骨骼损伤常常是首要线索,有助于集中进一步的检查。普通X线片和常规造影检查足以评估大多数腹内损伤。如果时间允许,大多数医院还可采用多种其他放射学技术。核成像在研究肝脏、脾脏和肾脏方面具有重要价值。到目前为止,超声技术虽然理论上有很大潜力,但仍有许多不足之处。血管造影具有很大的诊断价值,并且可能具有一定的治疗价值。没有任何诊断检查能胜过详细的病史和仔细的体格检查。理想情况下,进行放射学检查应该是为了证实临床怀疑,而不仅仅是为了“完善检查”。