创伤性膈肌破裂14例临床分析

创伤性膈肌破裂(traumatic diaphragmaticrupture,TDR)多由胸腹钝挫伤或穿通伤所致,对伤员危害十分严重,且早期常不易做出诊断而漏诊。作者总结了近10年(1984～1994)来收治的创伤性膈肌破裂14例,并重点分析了创伤性膈肌破裂的早期诊断及漏诊原因。     

创伤性膈肌破裂

创伤性膈肌破裂是严重威胁人类健康的疾病。目前,提高创伤性膈肌破裂诊断率的最好方法是提高临床医生面对严重胸腹部伤的警惕性。本文综述了国内外创伤性膈肌破裂的研究进展,重点介绍了创伤性膈肌破裂的不同诊断及治疗方法。     

创伤性膈肌破裂的诊治体会

分析1982—01--2002—01间76例创伤性膈肌破裂的临床资料。结果提示多种因素的影响造成创伤性膈肌破裂的早期诊断，多种检查方法的综合应用、连续观察是早期诊断创伤性膈肌破裂的关健。治疗上应采用以手术为主的综合治疗方法。     

创伤性膈肌破裂

探讨创伤性膈肌破裂的诊断及治疗。作者认为对本病X线检查仍有诊断意义 ;膈肌破裂应及时手术 ,术中应强调全伤道探查及无张力膈肌修补 ;电视胸、腹腔镜在本病中的应用正逐渐被重视     

创伤性膈肌破裂与膈疝的救治

创伤性膈肌破裂（traumatic diaphragnmtic rupture，TDR）是一种特殊类型的损伤，因其伤情的隐蔽性和复杂性，进展迅速，并发症较多，漏诊也时有发生，死亡率较高，均给临床救治带来一定的困难，早期的正确诊断和及时处理十分重要。我院自1988年4月至2005年12月收治创伤性膈肌破裂患者35例。现总结救治体会报告如下。     

创伤性膈肌破裂的急救处理

总结创伤性膈肌破裂的急救处理经验。回顾23例患者急救及手术方法,23例中治愈出院22例,死亡1例。笔者认为详细了解伤情、确定诊断、及时治疗合并伤是救治创伤性膈肌破裂的关键。     

创伤性膈肌破裂的诊治体会

对18例创伤性膈肌破裂临床资料进行回顾分析,术前确诊15例,治愈15例,死亡3例。及时手术探查并修补膈肌裂口是创伤性膈肌破裂的首选手术方法,围手术期大量出血或术后严重并发症患者预后较差;正确处理并发症是提高其治愈率的关键。     

34例创伤性膈肌破裂的早期诊断和外科治疗

目的总结创伤性膈肌破裂（TDR）的早期诊断和外科治疗的临床经验。方法回顾性分析1995年1月-2006年12月我院收治的34例创伤性膈肌破裂（TDR）患者的临床资料，对其发病原因、合并伤、诊断及手术途径分别进行分析。结果34例术前确诊14例，治愈32例，死亡2例。结论早期诊断和积极治疗是救治创伤性膈肌破裂的关键。     

创伤性膈肌破裂

总结创伤性膈肌破裂的诊断和治疗经验。分析致伤原因、手术方式、误诊教训。认为胸腹部创伤要注意致伤原因、创伤部位等因素;胸部X线透视是可靠的检查方法;手术应仔细检查膈肌;创伤性膈疝应尽快手术治疗。     

创伤性膈肌破裂的诊断与治疗

对23例创伤性膈肌破裂的致伤机制、临床表现、辅助检查、手术方法进行了回顾性分析。术前确诊15例、术中发现8例;手术治愈21例、死亡2例。创伤性膈肌破裂易被合并伤掩盖,发生膈疝极易绞窄,早期诊断及时手术尤为重要。     

CT findings of rupture, impending rupture, and contained rupture of abdominal aortic aneurysms

OBJECTIVE: With the increasing use of cross-sectional imaging for a variety of medical and surgical conditions affecting the abdomen and pelvis, familiarity with the imaging features of aneurysm rupture--and the findings suspicious for impending or contained aneurysm rupture--is crucial for all radiologists. This pictorial essay will review the imaging findings of rupture of abdominal aortic aneurysms and of complicated aneurysms. CONCLUSION: Prompt detection of abdominal aortic aneurysm rupture or impending rupture is critical because emergent surgery may be required and patient survival may be at stake.     

Idiopathic bladder rupture

Deaths due to hemoperitoneum are not rare and can result from a variety of underlying pathologic processes, including natural disease as well as trauma. Whenever hemoperitoneum is identified at autopsy, it is incumbent upon the pathologist to identify the source of the hemorrhage. The authors present a case of probable traumatic rupture of the urinary bladder that resulted in lethal intra-abdominal hemorrhage, occurring in a young man who was found dead the morning after drinking heavily.     

Spontaneous splenic rupture

Spontaneous splenic rupture is a rare entity. It is usually associated with infectious, neoplastic, or hematologic diseases. Unlike traumatic splenic rupture, spontaneous rupture of the spleen is not often considered in the differential diagnosis of abdominal pain and can be easily confused with other abdominal pathology. Failure to consider splenic rupture can be catastrophic. We report a case of atraumatic splenic rupture in a patient with no underlying disease pathology. This illustrates the importance of keeping a broad differential in patients presenting with acute abdominal pain and should remind the physician to consider the diagnosis of spontaneous nontraumatic splenic rupture.     

Intraventricular abscess rupture

Summary The clinical features and course of a patient who survived rupture of a cerebral abscess into the lateral ventricle are described and the brain scan and radiographic findings shown. A review of the literature reveals only four reports of patients who have survived under such circumstances. The importance of antibiotic therapy given early in the course of the disease is emphasized.

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Ruptur eines Hirnabszesses in das Ventrikelsystem

Zusammenfassung Beschreibung der klinischen Symptomatik, des Verlaufes und der radiologischen Zeichen (Hirnszintigraphie, Pneumoencephalographie, Carotisaeteriographie) bei einem Patienten, bei dem es zur Ruptur eines Hirnabszesses in einen Seitenventrikel kam. Unter antibiotischer Therapie überlebte der Patient diese Abszeßruptur.

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Rupture d'un abcès intra-ventriculaire

Résumé Les auteurs exposent le tableau clinique et l'évolution d'un patient qui a survécu à la rupture d'un abcès cérébral dans le ventricule latéral. Il présente le scintigramme cérébral et les données radiographiques. Une revue de la littérature ne révèle que 4 cas de malades ayant survécu dans de telles circonstances. Les auteurs soulignent l'importance de l'installation précoce de l'antibiothérapie dans l'évolution de la maladie.