腹部闭合性损伤(英文版).ppt

DCS Damage control surgery?(DCS) is a technique of surgery utilized to care for critically ill patients. While typically?trauma surgeons?are heavily involved in treating such patients, the concept has evolved to other sub-specialty services. This technique places emphasis on preventing the lethal triad, rather than correcting the?anatomy DCS Damage Control I – Initial laparotomy DCII – ICU Resuscitation DCIII – Definitive Reconstruction? a multi-disciplinary group of individuals are required. Anywhere from nurses, to respiratory therapist, surgical/medicine intensivist, blood bank personnel and others. The second festival 1 、Rupture of the spleen 2 、Rupture of the liver 3 、Rupture of the small bowel 4 、Rupture of the large bowel 一、Splenic Rupture The incidence of the splenic rupture in abdominal injury is 40 - 50%，the most easily damaged, the pathology of the spleen are more prone to rupture. Three types （1）Subcapsular rupture ( Film without rupture) （2）Central rupture :form a hematoma （3） true splenic rupture 85% Clinical manifestations and diagnosis ：Typically hemorrhagic shock performance Traumatic rupture of the spleen on contrast enhanced axial CT (portal venous phase) Spleen, trauma. Contrast-enhanced CT scan of the abdomen shows some perisplenic fluid in the anterior aspect. A small well-defined irregularity is noted in the splenic wall posteriorly. This was a congenital splenic cleft in a patient with perisplenic fluid secondary to nonsplenic injury. Spleen, trauma. Chest radiograph shows a peripherally calcified mass in the left upper quadrant under the diaphragm. The mass represents a calcified splenic hematoma. Spleen, trauma. Contrast-enhanced CT scan shows a localized area of dense contrast collection in the splenic hilum, with a massive amount of surrounding fluid/blood. Findings here are indicative of active extravasation of contrast in a patient with traumatic autosplenectomy. This is a grade V injury. Spleen, trau