常见腹部外伤的识别,处理（Identification and treatment of common abdominal trauma）.docVIP

常见腹部外伤的识别,处理（Identification and treatment of common abdominal trauma） Identification and treatment of common abdominal trauma I. overview 1, classification Penetrating injury (rupture of peritoneum) Open wound (rupture of abdominal wall) Non penetrating injury (without peritoneal damage) Closed injuries (without rupture of the abdominal wall) are often caused by blunt violence The clinical visible iatrogenic injury 2 、 clinical manifestation Injury of parenchymal organs or large vessels - intraperitoneal hemorrhage (mainly) The peritoneal irritation sign is usually not heavy; there may be abdominal mass (haematoma), mobility, dullness, hematuria, etc. The liver and pancreas injury may have obvious peritonitis Cavity organ damage diffuse peritonitis (mainly) The amount of bleeding is usually not large. There may be gastrointestinal symptoms, pneumoperitoneum, systemic infection and so on A certificate of peritoneal irritation (tenderness + pain + muscle tension) The adjacent vascular injury with bleeding 3 、 diagnosis Open wound whether penetrating wound!!! Closed injury There is no visceral injury A detailed understanding of the history of abdominal pain with shock, injury, digestive tract The importance of systemic conditions to observe the symptoms and signs of peritonitis, shifting dullness, hematemesis and hematochezia, pneumoperitoneum, rectal examination of blood, consider the abdominal injury The physical examination The laboratory examination What organ damage What kind? What kind? Substantive? Cavity? Urinary organs?... Outside the abdominal injury with the abdominal a multi organ damage, multiple organ damage and injuries involving the abdominal organs - whether multiple injuries 1 - diagnostic abdominal paracentesis Puncture point: the intersection between the point of wheat or the umbilical line and the front of the armpit Extract: non coagulation - parenchymal organ rupture or vascular injury? Clot blood, puncture, puncture, or hematoma? Bile to liver?