骨盆骨折伴腹膜后大量血肿1例

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL
D. Krishtafor, A. Krishtafor, A. Tsarev, D. Balyk, A.Y. Halushchak, V.A. Pelekh
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引用次数: 0

摘要

骨盆骨折是一种具有显著死亡风险的严重损伤。这些受害者的死因是腹膜后血肿和大出血的形成。这篇文章介绍了一个临床病例,骨盆骨折伴大量腹膜后血肿,一名30岁男子从5楼坠落5小时后因失血性休克被送往地区医院。入院时,计算机断层扫描(CT)显示耻骨关节破裂,骶骨多碎片性骨折,骨盆右侧出现血肿。尽管对骨折进行了固定和大量输血,但仍无法稳定患者的血流动力学并改善患者的一般血液分析参数。由于临床表现为活动性出血,患者多次对腹腔及胸膜窦进行对照超声检查,但治疗12小时后才确认腹腔内有游离液体。急诊开腹时发现血肿,经腹膜后间隙扩散至膈脚及小肠肠系膜根部,呈较薄一层,故超声或CT无法显示。尽管采取了重症监护措施,在接下来的几天里,病人的病情逐渐恶化,出现了多器官衰竭。术后第3天,患者因进行性多器官功能衰竭死亡。所描述的情况表明,严重的情况下,受害者与创伤性腹膜后血肿和诊断的困难和有效的治疗使用保守的方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical case of a pelvic fracture with massive retroperitoneal hematoma
Pelvic fracture is a serious injury that carries a significant risk of mortality. The cause of death in these victims is the formation of a retroperitoneal hematoma and massive bleeding. The article presents a clinical case of a pelvic fracture with a massive retroperitoneal hematoma in a 30-year-old man who was brought to the regional hospital in hemorrhagic shock 5 hours after falling from the 5th floor. Upon admission, computed tomography (CT) showed a rupture of the pubic joint, a multifragmentary fracture of the sacrum, and the presence of a hematoma in the right parts of the pelvic cavity. Despite immobilization of the fracture and massive transfusion, it was not possible to stabilize the patient's hemodynamics and improve the parameters of the patient's general blood analysis. Due to the clinic of active bleeding, the patient repeatedly underwent control ultrasound examinations of the abdominal cavity and pleural sinuses, but the presence of free fluid in the abdominal cavity could be confirmed only after 12 hours of treatment. At the emergency laparotomy, a hematoma was found, which spread through the retroperitoneal space to the level of the diaphragmatic crura and the root of the small-bowel mesentery in a relatively thin layer, which explained the impossibility of its visualization by ultrasound or CT. Despite the intensive care measures, over the next few days the patient's condition gradually worsened, multiple organ failure developed. On the 3rd day after the operation, the patient died due to progressive multiple organ failure. The described case demonstrates the severity of the condition of victims with a traumatic retroperitoneal hematoma and the difficulty of diagnosis and effective treatment using conservative methods.
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来源期刊
Medical Perspectives-Medicni Perspektivi
Medical Perspectives-Medicni Perspektivi MEDICINE, GENERAL & INTERNAL-
CiteScore
0.40
自引率
0.00%
发文量
85
审稿时长
9 weeks
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