Johansson L, Jönsson A, Norrby K, Lennquist S
Acta Chir Scand. 1984;150(2):165-71.
Intramural haemorrhage of the intestine following blunt trauma to the abdomen has been described in several clinical studies. Though such lesions may have an innocent appearance at primary laparotomy, they lead to delayed intestinal perforation in some cases. In previous experiments with similar lesions produced by penetrating abdominal missile, the histologic appearance and the clinical course were documented in pigs observed under long-term anaesthesia. In the present study anaesthetized pigs were submitted to blunt abdominal trauma in an impact machine, whereby the impact velocity could be regulated. The intra-abdominal pressure and the delivered impulse were recorded and the incidence and histologic appearance of intestinal injuries were observed at laparotomy immediately after the trauma. Intramural haemorrhage was found to occur when the impact velocity exceeded 5 m/s. At impact velocity 20 m/s, intestinal rupture occurred primarily. The observed intramural haemorrhages had the same histologic appearance as those seen after penetrating missile injury. The same clinical course, consequently, could be anticipated after blunt trauma.
几项临床研究中已描述了腹部钝性创伤后发生的肠壁内出血。尽管此类损伤在初次剖腹手术时可能外观并无异常,但在某些情况下会导致迟发性肠穿孔。在先前关于腹部穿透性导弹造成类似损伤的实验中,对长期麻醉下观察的猪记录了其组织学表现和临床病程。在本研究中,将麻醉后的猪置于冲击机中进行腹部钝性创伤,冲击速度可调节。记录腹内压和传递的冲量,并在创伤后立即剖腹手术时观察肠损伤的发生率和组织学表现。发现当冲击速度超过5米/秒时会发生肠壁内出血。在冲击速度为20米/秒时,主要发生肠破裂。观察到的肠壁内出血的组织学表现与穿透性导弹损伤后所见相同。因此,钝性创伤后可预期会出现相同的临床病程。