Kinnunen J, Kivioja A, Poussa K, Laasonen E M
Department of Diagnostic Radiology, Töölö Hospital, Helsinki, Finland.
Acta Radiol. 1994 Jul;35(4):319-22.
Multiple injury patients with blunt abdominal trauma (n = 110) were examined by abdominal CT. An i.v., but not peroral, contrast medium was used, thereby eliminating the delay caused by administering peroral contrast medium and any subsequent delay in making the diagnoses and beginning operative treatment. Eighteen patients underwent emergency laparotomy after the initial CT examination. The preoperative CT findings were compared to the laparotomy findings. CT revealed all but one of the severe parenchymal organ lesions requiring surgery. The one liver laceration that went undetected had caused hemoperitoneum, which was diagnosed by CT. The bowel and mesenteric lesions presented as intra-abdominal blood, and the hemoperitoneum was discovered in every patient with these lesions. Fourteen patients also initially had positive abdominal CT findings; 10 of them underwent an additional abdominal CT within 3 days, but the repeat studies did not reveal any lesions in need of surgery. Omission of the oral contrast medium did not jeopardize making the essential diagnoses, but it did save time.
对110例钝性腹部创伤的多发伤患者进行了腹部CT检查。使用静脉造影剂而非口服造影剂，从而消除了口服造影剂给药导致的延迟以及随后诊断和开始手术治疗的任何延迟。18例患者在初次CT检查后接受了急诊剖腹手术。将术前CT检查结果与剖腹手术结果进行比较。CT显示了除1例需要手术的严重实质器官损伤外的所有损伤。1例未被发现的肝裂伤导致了腹腔积血，CT诊断出了腹腔积血。肠和肠系膜损伤表现为腹腔内出血，每例有这些损伤的患者均发现了腹腔积血。另外14例患者最初腹部CT检查结果也为阳性；其中10例在3天内又进行了一次腹部CT检查，但复查未发现任何需要手术的损伤。省略口服造影剂并不影响做出基本诊断，但确实节省了时间。
