小儿延迟性脾破裂的诊断与治疗

目的 探讨小儿延迟性脾破裂的发生机理、诊断与治疗。方法 总结１６年来治的６例小儿延迟性脾破裂的临床资料，６例均为腹部闭合性损伤，伤后出现脾破裂症状的时间均在４８小时以上，经腹穿、ＣＴ或了超确诊，手术证实。结果 ６例中５例行脾切除术，１例行脾修补术，术后未发生暴发性感染，均痊愈。结论 小儿延迟性脾破裂容易误诊，应掌握其发生机理，提高对本病的认识和警惕性。有价值的影像学检查是提高诊断率、降低病死率的关

Delayed Splenic Rupture in Children: Diagnosis and Management

Objective To review the prognosis and the management of delayed rupture of spleen. Methods Retrospective study was carried out on 6 patients admitted over the last 16 years with blunt abdominal trauma. Delayed splenic rupture occurred more than 48 hours after the admission. The diagnosis was made by peritoneal lavage, CT scan, ultrasound and laparotomy. Results Five out of the 6 patients required splenectomy. One underwent splenorrhaphy. There was no overwhelming postsplenectomy infection. All recovered uneventfully. Conclusions Delayed diagnosis is common in delayed rupture of spleen. High index of suspicion and imaging studies are necessary in reducing the mortality.