[对腹膜腹部器官损伤的管理]
Stina Schild-Suhren1, Elif Yilmaz1, Lorenz Biggemann2
1Klinik für Allgemein-, Viszeral- und Kinderchirurgie, Universitätsmedizin Göttingen, Gottingen, Deutschland.
Zentralblatt fur Chirurgie
|April 29, 2024
概括
腹部创伤管理优先考虑脏和肝脏损伤. 血液动力学不稳定性和自由液体要求紧急腹腔切除术,而稳定的患者需要先进的成像,如对比度增强CT,以准确诊断和治疗计划.
科学领域:
- 创伤外科 手术 创伤外科
- 紧急医疗 紧急医疗
- 诊断成像 诊断成像 诊断成像
背景情况:
- 腹部创伤经常影响脏和肝脏,胰腺损伤很少见.
- 的腹部创伤比穿透创伤更常见.
- 最初的评估重点是血液动力学稳定性和识别自由液体.
研究的目的:
- 概述了对形和穿透腹部创伤的诊断和管理策略.
- 强调成像在伤害评估和治疗选择中的作用.
- 突出非手术治疗 (NOM) 对大多数腹部损伤的有效性.
主要方法:
- 临床和实验室检查,随后进行超声波检查,以检查重的创伤.
- 三相对比增强计算机断层扫描 (CECT) 用于稳定患者或多创伤患者.
- 如果怀疑血管损伤或活跃出血,进行血管图像检查;如果怀疑胰腺管损伤,进行内镜检查.
主要成果:
- 血液动力学不稳定与自由液体需要紧急腹腔切除术.
- 有异常超声波的稳定患者需要CECT进行详细的伤害分类.
- 对于大多数腹部损伤,非手术治疗 (NOM) 是成功的,手术只适用于特定的迹象.
结论:
- 循序渐进的诊断方法,以血液动力学状态和成像为指导,对于腹部创伤至关重要.
- 增强对比度的CT对于评估固体器官和血管损伤至关重要.
- 非手术治疗和最小侵入性技术越来越受欢迎,手术只适用于严重或不稳定的病例.
相关概念视频
Acute Pancreatitis II: Clinical Manifestations and Management
122
Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
122
Flail Chest-II
167
Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
Assessment:
1. Clinical Evaluation:
History:
167
Esophageal Perforation-II: Clinical Manifestations and Management
57
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
57
Assessment of the Abdomen III: Palpation
574
Palpation is a crucial tactile examination method for assessing abdominal organs and detecting conditions like tenderness, distention, masses, or fluid. It involves both light and deep palpation techniques, each serving specific diagnostic purposes. Light palpation helps identify tenderness and other surface-level indicators, while deep palpation locates and assess abdominal masses and organ boundaries. A skilled professional can gather valuable insights through palpation, including evaluating...
574
Appendicitis-II: Diagnostic Studies and Management
77
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
77
Abdominal Regions and Quadrants
8.0K
To promote clear communication, for instance, about the location of a patient's abdominal pain or a suspicious mass, anatomists and clinicians typically use imaginary lines to categorize the abdominopelvic cavity into either four quadrants or nine regions to identify organs in the cavity.
The simpler quadrants approach, which is more commonly used in medicine, subdivides the cavity with one horizontal and one vertical line that intersects at the patient's umbilicus (navel). The four...
The simpler quadrants approach, which is more commonly used in medicine, subdivides the cavity with one horizontal and one vertical line that intersects at the patient's umbilicus (navel). The four...
8.0K


