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1临床资料患者女,65岁,主因车祸伤及胸腹部3 h伴腹痛、腹胀、胸闷急诊入住当地医院。行头胸腹部计算机体层摄影(computed tomography,CT)显示,颅内未见明确异常;鼻骨骨折;左侧多发肋骨骨折,左侧胸腔积液;脾包膜下血肿,腹腔积液。考虑脾破裂。急诊行开腹探查,腹腔内吸出鲜血约1 000 ml,见脾脏粉碎性裂伤,胃底及前壁大片挫伤,范围约7.0 cm×5.0 cm,胃壁未破裂,胰尾处有挫裂伤。行脾切除术顺利,胰
1 clinical data Female, 65 years old, mainly due to traffic accidents and chest and abdomen 3 h with abdominal pain, abdominal distension, chest tightness emergency visit to the local hospital. Computed tomography (CT) of the thorax and abdomen revealed no clear anomaly in the skull; nasal bone fractures; multiple rib fractures on the left, left pleural effusions; subpleural hematomas and peritoneal effusions. Consider spleen rupture. The emergency department laparotomy, abdominal cavity aspiration of blood about 1 000 ml, see splenic comminuted laceration, gastric fundus and anterior large contusion, the range of about 7.0 cm × 5.0 cm, the stomach wall is not ruptured, pancreatic tail laceration. Splenectomy goes well, pancreas