Lenriot J P
Service de Chirurgie Viscérale et Digestive, Centre Hospitalier Général, Longjumeau.
Ann Chir. 1994;48(2):126-35; discussion 135-9.
Diagnosis of a deep visceral lesion in an adult following abdominal contusion is almost always difficult as the abdominal signs are late or masked by associated lesions. All of the controlled studies agree on the superiority of peritoneal puncture-lavage over ultrasonography or CT scan in the diagnosis of haemoperitoneum. The diagnostic performance of computed tomography in the identification of lesions of solid organs is very much better than that of ultrasonography. The diagnosis of an isolated lesion of a hollow viscus has benefited from progress in imaging to a much lesser degree and peritoneal puncture-lavage with leukocyte count remains the key examination. The diagnostic strategy must be based on the patient's clinical condition and on this hierarchy of complementary investigations.
诊断成人腹部挫伤后的深部内脏损伤几乎总是很困难，因为腹部体征出现较晚或被相关损伤掩盖。所有对照研究均认为，在诊断腹腔积血方面，腹腔穿刺灌洗优于超声检查或CT扫描。计算机断层扫描在识别实体器官损伤方面的诊断性能比超声检查要好得多。中空脏器孤立损伤的诊断在影像学进展方面受益程度小得多，白细胞计数的腹腔穿刺灌洗仍是关键检查。诊断策略必须基于患者的临床状况以及这种辅助检查的层次结构。
