腹部损伤英文课件.pptVIP

Abdominal Injury the outline the incidence of abdominal injuries in peacetime: 0.4%-1.8% in wartime : 50% the mortality of abdominal injuries is 10% Types of the abdominal injuries Mechanism of closed injury Direct impact Deceleration and rotational forces Spleen,kidney,small bowel and liver are the most commonly closed abdominal injuried organs. Mechanism of open injury Stab wounds Gunshot wounds Liver, small bowel, stomach and colon are commonly involved in the open abdominal injuries. The severity of the injuries and involved organs depend on the intensity , velocity, position and direction of the force . Abdominal anatomic features and the functions of the organs are also important to the injuries. clinical manifestations abdominal pain hemorrhagic shock peritonitis abdominal organs injuries are divided to solid and hollow organs injuries. the main manifestation of the solid organs injuries is hemorrhage that can lead to shock. the main manifestation of the hollow organs injuries is peritonitis. Hemorrhage and peritonitis can exist simultaneously,when the injuries involve the 2 kinds of abdominal organs. Diagnosis Accurate diagnosis and management requires a thorough history, physical examination, and, when indicated, laboratory tests. when we diagnose the injury as the open abdominal injury,we should consider if there is a penetrating injury. Diagnosis of the closed abdominal injury Does the abdominal organ injury exist? Which organ is injuried? whether multiple organs are involved in the abdominal injuries? when its still difficulty to diagnose, the following measures can be taken. ★ observing closely ①determine the pulse rate, respiratory rate, blood pressure every 15-30 minutes. ②examine the abdominal signs every 30 minutes. ③determine the erythrocyte number, hemoglobin, hematocrit every 30-60 minutes. ★ exploratory laparotomy The indications for laparotomy Abdominal pain and peritoneal irritation sign aggravate g