成熟创伤系统中的隔膜损伤:仍然是一个诊断挑战
S Karhof1, R K J Simmermacher1, P Gerbranda1
1Department of Surgery, University Medical Centre Utrecht, Utrecht, Netherlands.
Frontiers in surgery
|December 24, 2024
概括
创伤性隔膜损伤很罕见,但致命. 尽管成像技术取得了进步,但检测仍然具有挑战性,导致严重的发病率和死亡率. 在腹部创伤病例中,高度怀疑至关重要.
科学领域:
- 创伤外科 手术 创伤外科
- 诊断成像 诊断成像 诊断成像
- 胸部受伤 胸部受伤
背景情况:
- 创伤性隔膜缺陷并不常见,但如果错过,可能导致严重的后果.
- 在创伤患者中,对隔膜损伤的早期检测率在历史上很低.
- 医学成像技术的进步为改善诊断提供了潜力.
研究的目的:
- 为了分析20多年的创伤性隔膜损伤.
- 评估诊断工具,治疗干预和患者的结果.
- 为了确定诊断隔膜损伤的趋势和挑战.
主要方法:
- 对患有隔膜损伤的创伤患者 (2000-2018年) 的回顾性分析.
- 数据收集包括患者特征,诊断,治疗和随访.
- 在一级创伤中心进行的研究.
主要成果:
- 确定了47名患有创伤性隔膜损伤的患者,72%是由于重的创伤造成的.
- 死亡率为21%,通常是由于相关的伤害;一个死亡是由于未被识别的伤害造成的.
- 通过成像进行手术前诊断发生在62%的病例中,但CT扫描错过了35%的伤害.
结论:
- 隔膜损伤很少发生,但与高死亡率有关.
- 尽管成像技术得到了改进,但对隔膜损伤的诊断算法和结果并没有显著改变.
- 对于腹部创伤患者来说,怀疑的高指数至关重要,即使是不确定的CT扫描.
更多相关视频
11:27A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
6.1K
05:51Author Spotlight: Unraveling the Impact of Mechanical Ventilation on Diaphragm Function and Patient Outcomes
Published on: November 3, 2023
5.4K
相关概念视频
Flail Chest-II
134
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:
134
Flail Chest-I
107
Overview of Flail Chest
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
107
Pneumothorax-I
154
A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
154
Pneumothorax-II
104
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations:
104
Esophageal Perforation-I: Introduction
40
Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
40
Esophageal Perforation-II: Clinical Manifestations and Management
22
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:
22
