由于车把受伤造成的钝性腹部创伤。

María Jesús Irarrázaval Mainguyague, Josefina Sáez Binelli, Catalina Kychenthal Loyola, María Soledad Loyola Zunino, Fernando Vuletin Solís, Juan Carlos Pattillo Silva
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引用次数: 2

摘要

自行车事故是儿童钝性腹部创伤的常见原因。在智利,没有关于这类事故的科学文章,它们的表现和管理。目的:本研究的目的是描述三例儿童钝性腹部外伤,由于车把损伤,以说明不同类型的病变,他们的表现和处理。临床病例:1)一名11岁男孩在自行车车把上跌倒,伤及上腹部,急诊科就诊。CT扫描显示有十二指肠穿孔的迹象。行腹侧切开术,修复十二指肠穿孔。2) 14岁的男孩在一次自行车事故中被车把击中腹部后被送往急诊室。CT扫描显示脾损伤伴多处撕裂和活动性出血,经血管栓塞治疗。随访6周后,病变消退,脾脏恢复活力。3) 9岁男孩因腹部被自行车车把撞击而入院。CT扫描显示肝损伤,采用非手术治疗,随访8周后病变消退。结论:车把造成的钝性腹部创伤可能影响到实心和空心的腹部脏器,对儿科患者具有潜在的严重危害。非手术治疗越来越多地用于病情稳定的患者,取得了很高的成功率。不稳定的患者或怀疑有中空脏器穿孔的患者将需要手术作为第一途径。
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Blunt abdominal trauma due to handlebar injury.

Introduction: Bicycle accidents are a frequent cause of blunt abdominal trauma in children. In Chile, there are no scientific articles about such accidents, their presentation and management.

Objective: The aim of this study is to describe three cases of blunt abdominal trauma due to handlebar injury in children, in order to illustrate the different kinds of lesions, their presentation, and management.

Clinical cases: 1) 11-year-old boy presented to Emergency Department (ED) after falling on a bi cycle handlebar, hitting his epigastric region. A CT scan showed signs of duodenal perforation. A la parotomy was performed and the duodenal perforation repaired. 2) 14-year-old boy seen at ED after a bicycle accident in which the handlebar hit him in the abdomen area. A CT scan showed a splenic injury with multiple lacerations and active bleeding that was treated with angioembolization. After 6 weeks of follow-up, he presented resolution of the lesion and viability of the spleen. 3) 9-year-old boy admitted due to a hit with the bicycle handlebar on the abdomen area. A CT scan showed a he patic injury that was managed with non-surgical procedures, achieving resolution of the lesion after 8 weeks of follow-up.

Conclusion: Blunt abdominal trauma caused by handlebar can be potentially serious in pediatric patients, since it may affect solid and hollow abdominal viscera. Non-surgical ma nagement is becoming more used for stable patients, achieving high success rates. Unstable patients or those with suspicion of hollow viscera perforation will require surgery as first approach.

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