The role of computed tomography in blunt abdominal trauma in children.
The role of computed tomography in blunt abdominal trauma in children.
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DOI：
10.1097/00005373-198812000-00008
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发表时间：
1988-12
期刊：
影响因子：
--
通讯作者：
G. Taylor;M. Fallat;B. Potter;M. Eichelberger
中科院分区：
文献类型：
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作者：
G. Taylor;M. Fallat;B. Potter;M. Eichelberger
本研究旨在验证腹部计算机断层扫描（CT）可以帮助腹部钝伤儿童决定是否进行剖腹手术的假设。本文对340例闭合性腹部创伤患儿进行了CT检查。84名儿童（25%）发现腹部损伤。其中包括：60例患者中75例实体脏器损伤（30例脾、29例肝、13例肾和3例胰腺）; 4例中空脏器损伤（3例小肠横断和1例膀胱破裂）; 23例骨骼损伤（21例骨盆骨折和2例腰椎半脱位）。根据对实质受累百分比的评估，32例（43%）实体脏器损伤被分类为轻度，18例（24%）中度，25例（33%）重度。在42名患者中检测到腹腔积血，其特征为18名（43%），9名（21%）和15名（36%）。CT有助于确定损伤的位置和范围，并检测腹腔内是否存在血液或空气。然而，CT上检测到的实体脏器损伤程度与是否需要剖腹手术无关。在46例中度至重度肝、脾或肾解剖损伤中，只有5例（9%）因持续出血或感染需要手术干预。虽然在存在大量腹腔积血的情况下更常进行剖腹手术，但只有6/24例（25%）中度至大量腹腔积血需要手术探查。这一分析证实了CT在小儿腹部钝性创伤中检测损伤位置和程度的有用性。（250字处删节）
This study was performed in order to test the hypothesis that abdominal computed tomography (CT) can assist in the decision to perform laparotomy in children following blunt trauma to the abdomen. Three hundred forty children with blunt abdominal trauma underwent evaluation with CT. Abdominal injuries were detected in 84 children (25%). These included: 75 injuries to solid viscera in 60 patients (30 splenic, 29 hepatic, 13 renal, and three pancreatic); four injuries to hollow viscera (three small bowel transections, and one rupture of the urinary bladder); and 23 skeletal injuries (21 fractures of the pelvis, and two lumbar spine subluxations). Injury to solid viscera was categorized as minor in 32 (43%), moderate in 18 (24%), or severe in 25 (33%) according to an assessment of the percentage of parenchyma involved. Hemoperitoneum was detected in 42 patients, and characterized as small in 18 (43%), moderate in nine (21%), and large in 15 (36%). CT was useful in establishing the location and extent of injuries, and in detecting the presence of blood or air in the peritoneal cavity. However, the extent of injury to solid viscera detected on CT did not correlate with the need for laparotomy. Of 46 moderate to severe anatomic injuries of the liver, spleen or kidney, only five (9%) required surgical intervention because of persistent bleeding or infection. Although laparotomy occurred more frequently in the presence of a large hemoperitoneum, only 6/24 (25%) with moderate to large hemoperitoneum required surgical exploration. This analysis confirms the usefulness of CT for detection of location and extent of injury in pediatric blunt abdominal trauma.(ABSTRACT TRUNCATED AT 250 WORDS)