Kluger Y, Paul D B, Raves J J, Fonda M, Young J C, Townsend R N, Diamond D L
Medical College of Pennsylvania, Division of General Surgery, Allegheny General Hospital, Pittsburgh 15212.
J Trauma. 1994 Apr;36(4):568-71.
Over a 1-year period, three patients were seen in our trauma service with delayed bleeding (> or = 7 days) from an initially inapparent splenic injury. This entity was defined as a late occurrence of signs and symptoms attributed to splenic injury not detected by diagnostic computed tomographic (CT) scanning during the initial examination. We believe that this represents an "injury in evolution" minor enough to go undetected on initial CT scans of the abdomen. A high index of suspicion and liberal utilization of imaging techniques are essential for the identification of delayed splenic rupture. Further multicenter studies are required to delineate the true incidence of its occurrence and its clinical significance. We conclude that "delayed rupture" of the spleen is a true clinical entity. The occurrence of a delayed rupture may prove hazardous to patients discharged early from the hospital after blunt abdominal injury. A classification system to assess this type of injury is suggested.
在1年的时间里，我们创伤科诊治了3例患者，他们最初脾脏损伤不明显，但出现了延迟性出血（≥7天）。这种情况被定义为最初检查时诊断性计算机断层扫描（CT）未检测到的脾脏损伤所导致的体征和症状的延迟出现。我们认为这代表了一种“渐进性损伤”，其程度较轻，在腹部初始CT扫描时未被发现。高度的怀疑指数和广泛应用成像技术对于识别延迟性脾破裂至关重要。需要进一步的多中心研究来明确其真实发生率及其临床意义。我们得出结论，脾脏“延迟破裂”是一种真实的临床实体。延迟破裂的发生可能对钝性腹部损伤后早期出院的患者构成危险。建议建立一个评估此类损伤的分类系统。
