Danzl D F, Berg B C
JACEP. 1977 Sep;6(9):397-404. doi: 10.1016/s0361-1124(77)80004-x.
The emergency management of blunt abdominal trauma requires rapid assembly of accurate information. But history, physical findings and conventional tests may be unreliable. As a result, peritoneal lavage is an integral part of the initial diagnostic protocol in many centers. However, confusion in interpretation, especially of "weak positives," can result in delayed or unnecessary celiotomy. In our regional trauma center, lavage is now reserved for selected cases based on experience with 1,833 cases "scanned" during a five-year period. The indications, contraindications, techniques, interpretation, advantages, disadvantages, and complications of lavage and scanning are presented. A protocol using radionuclide imaging for initial evaluation of blunt abdominal trauma is proposed and representative case studies are included to support this approach.
钝性腹部创伤的急诊处理需要快速收集准确信息。但病史、体格检查结果及传统检查可能不可靠。因此，在许多中心，腹腔灌洗是初始诊断方案的一个组成部分。然而，解读方面的混淆，尤其是对“弱阳性”结果的解读，可能导致剖腹手术延迟或不必要。在我们的地区创伤中心，基于五年内对1833例患者进行“扫描”的经验，目前腹腔灌洗仅用于特定病例。本文介绍了腹腔灌洗及扫描的适应证、禁忌证、技术、解读、优缺点及并发症。提出了一种使用放射性核素成像对钝性腹部创伤进行初始评估的方案，并纳入了代表性病例研究以支持该方法。
