DELAYED RUPTURE OF THE SPLEEN

被引：17
作者：
DANG, C
SCHLATER, T
BUI, H
OSHITA, T
机构：
[1] Department of Emergency Medicine, King/Drew Medical Center, Los Angeles, CA
[2] Department of Surgery, King/Drew Medical Center, Los Angeles, CA
[3] Patton State Hospital, Patton, CA
来源：
ANNALS OF EMERGENCY MEDICINE | 1990年 / 19卷 / 04期
关键词：
spleen; delayed rupture;
D O I：
10.1016/S0196-0644(05)82346-7
中图分类号：
R4 [临床医学];
学科分类号：
1002 ; 100602 ;
摘要：
The concept of delayed splenic rupture is an evolving one. The cases reviewed have led us to reserve the term "delayed splenic rupture" for the situation in which early post-traumatic imaging of the spleen is normal and is followed by the diagnosis of splenic hemorrhage 48 or more hours after the initial insult. Post-traumatic splenic evaluation is indicated when the mechanism of injury is likely to injure the spleen, there is unexplained hypovolemia, or the patient complains of left upper quadrant pain or tenderness. Peritoneal lavage is indicated when hypovolemia is the main manifestation. Radionuclide study is used for screening isolated splenic or hepatic injury when the suspicion is low. Reduced availability of visceral angiogram has resulted in CT scan becoming the main diagnostic modality. When a patient presents with blunt abdominal trauma, awareness of the problem of splenic rupture and active diagnostic approach may help reduce the morbidity and mortality associated with splenic hemorrhage, either immediate or delayed. © 1990 American College of Emergency Physicians.
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收藏
页码：399 / 403
页数：5
相关论文
共 42 条
  • [1] Olsen, Polley, A second look at delayed splenic rupture, Arch Surg, 112, pp. 422-425, (1977)
  • [2] Ballance, On splenectomy for rupture without external wound, Practitioner, 60, pp. 347-358, (1898)
  • [3] Baudet, Ruptures de la rate, Med Pract, 3, pp. 565-567, (1907)
  • [4] Berlatzky, Shiloni, Anner, Et al., “Delayed rupture of the spleen” or delayed diagnosis of the splenic injury?, 1st J Med Sci, 16, pp. 659-664, (1980)
  • [5] Benjamin, Engrav, Perry, Delayed rupture or delayed diagnosis of rupture of the spleen, Surg Gynecol Obstet, 142, pp. 171-172, (1976)
  • [6] McIndoe, Delayed hemorrhage following traumatic rupture of the spleen, British Journal of Surgery, 20, pp. 249-268, (1932)
  • [7] Zabinski, Harkins, Delayed splenic rupture A clinical syndrome following trauma, Archives of Surgery, 46, pp. 186-213, (1943)
  • [8] Olsen, Delayed rupture of the spleen as an index of diagnostic accuracy, Surg Gynecol Obstet, 138, (1974)
  • [9] Hertzanu, Mendelsohn, Delayed splenic rupture: A true entity, Clin Radiol, 35, pp. 393-396, (1984)
  • [10] Fabian, Mangiante, White, Et al., A prospective study of 91 patients undergoing both computed tomography and peritoneal lavage following blunt abdominal trauma, J Trauma, 26, pp. 602-607, (1986)
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