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浙江省医学会创伤学分会成立大会暨2009年浙江省创伤学术年会

作者： CHEN Zuo-bing~*,ZHANG Yun~*,LIANG Zhong-yan~*,ZHANG Shao-yang~*,YU Wen-qiao~*, GAO Yuan#,ZHENG Shu-sheng# *Department of Emergency Surgery,# Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital,College of Medicine, Zhejiang University,Hangzhou,China,(310003)

Background:The presence of free fluid without solid organ injury in patients with blunt abdominal injury(BAT) unceasingly present a diagnostic dilemma for the *** purpose of this study is to analysis the incidence of unexplained free fluid in BAT and it’s diagnostic significance in hollow viscus ***:All patients presenting with BAT to a provincial trauma center over a 10 year period were *** stable patient was underwent computed tomographic(CT) *** with free fluid but without visible free air or solid organ injury were *** management and operative findings were ***:28 of 597 patients(4.69%) met inclusion criteria.19 patients(3.18%) underwent therapeutic exploratory laparotomy:bowel injuries were found in 13 patients,colon rupture in 3,Duodenal rupture in 2 and cholecyst perforation in *** 2 patients,laparotomy was *** with moderate or large amount of free fluid were significantly more likely to suffer hollow viscus injury and have a therapeutic *** mean length of stay of delay *** were longer compared with the emergency one significantly(19 days,12 days;phollow vicus injury and the need for emergencyt *** rate of this kind of injury requiring surgical intervention was high,particularly for those with moderate or large amounts of free *** laparotomy is recommended for these patients.

关键词： blunt abdominal injury(BAT) hollow viscus free fluid Computed tomography(CT)

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Incidence of unexplained intra-abdominal free fluid in patients with blunt abdominal trauma

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Hepatobiliary & Pancreatic Diseases International 2009年第6期8卷 597-601页

作者： Chen, Zuo-Bing Zhang, Yun Liang, Zhong-Yan Zhang, Shao-Yang Yu, Wen-Qiao Gao, Yuan Zheng, Shu-Sen Zhejiang Univ Sch Med Affiliated Hosp 1 Dept Gen Surg Hangzhou 310003 Zhejiang Peoples R China Zhejiang Univ Sch Med Affiliated Hosp 1 Dept Emergency Surg Hangzhou 310003 Zhejiang Peoples R China

BACKGROUND: Intra-abdominal free fluid is commonly caused by injuries of solid or hollow organs in patients suffering from blunt abdominal trauma (BAT). However, it presents a diagnostic dilemma for surgeons when free fluid is unexplained, especially in stable BAT patients. This study was to analyze the incidence of such unexplained free fluid in BAT patients and its diagnostic value in abdominal organ injury. METHODS: Altogether 597 patients with BAT who had been treated at our trauma center over a 10-year period were reviewed. Stable patients with free fluid but without free air or definite organ injury on abdominal computed tomography were studied. Clinical management and operative findings were analyzed. RESULTS: Thirty-four (5.70%) of the 597 patients met the inclusion criteria: 24 (4.02%) underwent therapeutic exploratory laparotomy: bowel injuries were found in 13, hepatic rupture in 3, colon rupture in 3, duodenal rupture in 2, spleen rupture in 1, pancreas rupture in 1, and gallbladder perforation in 1. In 2 patients, laparotomy was nontherapeutic. Those with moderate or large amounts of free fluid were more likely to suffer from a hollow viscus injury and have a therapeutic procedure. The mean time of hospital stay for the delayed laparotomy group was longer than that for the emergency group (19 5.12 vs. 12 2.24 days; t=2.73, Phollow organ injury. Emergency laparotomy is recommended for these patients.

关键词： blunt abdominal injury hepatic rupture hollow viscus free fluid computed tomography

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