Becker C D, Mentha G, Terrier F
Department of Radiology, Division of Diagnostic and Interventional Radiology, Geneva University Hospital, 24, Rue Micheli-du-Crest, CH-1211 Geneva 14, Switzerland.
Eur Radiol. 1998;8(4):553-62. doi: 10.1007/s003300050433.
Computed tomography is now widely used in the initial diagnostic workup of adult trauma victims with suspected intra-abdominal injuries. We review the role of CT in the detection and management of blunt visceral injuries in two parts. In the first part we discuss general aspects of performing CT in the setting of abdominal trauma and the diagnostic findings of intra-abdominal hemorrhage and blunt hepatic and splenic injuries. Hepatic and splenic injuries can be detected by means of CT with a high accuracy. The vast majority of hepatic injuries can be successfully managed conservatively, even when CT demonstrates parenchymal damage of more than three segments and major hemoperitoneum. Delayed complications, e. g., formation of biloma or a false aneurysm, can be readily detected on repeat CT studies, although they are quite uncommon. The outcome of conservative treatment of splenic injuries remains unpredictable because delayed splenic rupture may occur even when initial CT shows only minor parenchymal lesions and little or no intraperitoneal hemorrhage.
计算机断层扫描现已广泛应用于疑似腹部内伤的成年创伤患者的初始诊断检查。我们分两部分回顾CT在钝性内脏损伤的检测和管理中的作用。在第一部分中，我们讨论在腹部创伤情况下进行CT检查的一般方面以及腹腔内出血和钝性肝脾损伤的诊断结果。肝脾损伤可以通过CT高精度检测出来。即使CT显示超过三个肝段的实质损伤和大量腹腔积血，绝大多数肝损伤也可以成功地进行保守治疗。尽管延迟性并发症，如胆汁瘤或假性动脉瘤的形成相当少见，但在重复CT检查中很容易检测到。脾损伤保守治疗的结果仍然不可预测，因为即使初始CT仅显示轻微的实质病变且腹腔内出血很少或没有，也可能发生延迟性脾破裂。
