Taylor B
Can Med Assoc J. 1977 Mar 19;116(6):599-605.
The assessment of a case of blunt abdominal trauma can be complicated by many factors, and the resultant inaccurate or delayed diagnoses have contributed to the unacceptable mortality for this type of injury. Recently several useful diagnostic techniques have been developed that, if applied intelligently, may be instrumental in decreasing the high mortality among patients who present with ambiguous abdominal signs after sustaining blunt trauma. Although hematologic investigation and routine radiography have facilitated detection of intraperitoneal injury, peritoneal lavage has become the single most helpful aid. Scanning procedures are sometimes useful in recognizing splenic and hepatic defects especially; these may be confirmed or clarified by angiography. Although ultrasonography may be no more valuable than scintigraphy in outlining splenic and hepatic abnormalities, it is an important technique, especially in the diagnosis of retroperitoneal masses of traumatic origin. Laparoscopy also may be helpful in investigation if surgeons become more familiar with the procedure.
钝性腹部创伤病例的评估可能会因多种因素而变得复杂，由此导致的不准确或延迟诊断致使这类损伤的死亡率高得令人无法接受。最近已开发出几种有用的诊断技术，如果合理应用，可能有助于降低钝性创伤后出现腹部体征不明确的患者的高死亡率。尽管血液学检查和常规放射照相有助于发现腹腔内损伤，但腹腔灌洗已成为最有帮助的单项检查。扫描程序有时在识别脾脏和肝脏损伤方面很有用，尤其是；这些损伤可通过血管造影得到证实或明确。尽管超声检查在勾勒脾脏和肝脏异常方面可能并不比闪烁扫描更有价值，但它是一项重要技术，特别是在诊断创伤性腹膜后肿块方面。如果外科医生对该手术更加熟悉，腹腔镜检查在诊断中也可能会有帮助。
