Early symptoms of internal bleeding, teach you three characteristics and treatment

Internal bleeding is a very serious problem. Some people in life often don’t notice when they have internal bleeding. If they don’t seek treatment until it becomes serious, it will delay the disease. Therefore, we must take care of our bodies and pay more attention to our physical condition. Today, let us learn about the early symptoms of internal bleeding.

Characteristics and management of common visceral injuries

1. Splenic rupture:

1. Clinical type:

Central rupture, subcapsular rupture, true rupture (may cause massive bleeding and hemorrhagic shock)

2. Clinical characteristics;

①The spleen is the most easily damaged organ in the abdomen

②85% of spleen injuries involve rupture of the spleen capsule and parenchyma, with internal bleeding and hemorrhagic shock as the main manifestations. ③Sometimes combined with left lower rib fracture

3. Grading of spleen injury grade IV

Grade I: subcapsular rupture of the spleen or mild damage to the capsule and substance. During surgery, the length of the splenic laceration is ≤5.0 cm and the depth is ≤1.0 cm.

Grade II: Splenic laceration length > 5.0 cm, depth > 1.0 cm, but the splenic hilum is not involved, or the splenic segmental vessels are involved

Grade III: Splenic rupture involving the hilum or splenic septum, or involvement of splenic lobe vessels Grade IV: Extensive rupture of the spleen, or involvement of the splenic pedicle, splenic artery and vein trunks

4. Treatment principles:

① In principle, emergency surgery should be performed

② Splenectomy is often used; if conditions permit, some people currently advocate spleen-preserving surgery for children

③ For a small number of patients with mild spleen rupture, small amount of bleeding, and no hemorrhagic shock, non-surgical treatment can be performed under close observation.

④ Laparoscopic hemostasis or repair can be performed for smaller lacerations

2. Liver rupture:

1. Clinical type:

Central rupture, subcapsular rupture, true rupture (may cause massive bleeding and hemorrhagic shock)

2. Grading of liver damage - self-study

3. Clinical characteristics:

①Accounts for about 15% of all abdominal injuries, mostly occurring on the right hemiliver

② Because bile enters the abdominal cavity, obvious peritoneal irritation symptoms may occur at the same time as blood loss.

③After liver rupture, blood can enter the duodenum through the bile duct, causing gastrointestinal bleeding

4. Principles of surgical treatment:

Temporarily control the bleeding and find out the injury as soon as possible

For simple lacerations less than 2 cm in depth, simple suture repair can be performed;

Severe liver trauma requires thorough debridement and hemostasis, and debridement and liver resection if necessary; gauze packing has a certain application value to provide adequate drainage on the wound surface and around the liver.

3. Pancreatic injury: Steering wheel injury

1. Clinical characteristics:

It is rare, accounting for about 1-2% of abdominal organ injuries. The main symptoms after injury are abdominal pain and signs of peritonitis. Pancreatic fistula after injury has a mortality rate as high as 10-20%.

Simple pancreatic contusion is prone to delayed diagnosis. Patients with more severe pancreatic injury may present with upper abdominal or even whole abdominal peritonitis. Peritoneal fluid and serum amylase determination, ultrasound, and CT examinations are helpful in diagnosing pancreatic injury. Pancreatic pseudocysts may form in the late stage of pancreatic injury.

2. Treatment principles:

① The principle of surgical treatment is to thoroughly clean the wound, completely stop bleeding, stop pancreatic fluid leakage and deal with associated injuries.

② If the pancreatic body is partially ruptured but the main pancreatic duct is not ruptured, it can be repaired by suture; if the body and tail are ruptured, it can be resected; if the head of the pancreas is ruptured, the tumor can be removed.

In addition to tying the main pancreatic duct on the head side and suturing the gland stump, the tail side can be anastomosed to the jejunum; severe pancreatic head combined with duodenal injury can be treated with duodenal diverticulum surgery or pancreaticoduodenectomy. ③ After surgery, abdominal drainage must be placed.

④ If pancreatic fluid leakage occurs, fasting, intravenous nutrition, and somatostatin should be used