Left abdominal flexion

Introduction Left abdomen flexion is one of the clinical manifestations of spleen trauma. The typical symptom of simple spleen rupture is that the left upper abdomen is directly slammed or severely injured, and the child cannot stand upright immediately, especially the left abdomen flexion. I can't even stand up, and I like to go to the left and down, and bend forward, and I don't dare to move.

Cause

Cause:

More common in abdominal blunt injuries or falls, crashes, mostly indirect shocks, rarely direct damage. Often part of a severe closed injury such as a fall, a bruise, or a car accident, it is possible to diagnose a serious and obvious trauma such as a head injury, multiple fractures, etc., and ignore the spleen rupture, or diagnose the spleen rupture and ignore other organ damage health search. The spleen is a substantial organ with a high film tension and a crisp texture. It is a fixed organ in the abdomen, but it has a certain degree of mobility and is susceptible to strong vibration and rupture or tear.

The normal spleen is not easily injured under the protection of the left rib but under the strong earthquake, it is still the most easily ruptured organ in the abdomen. If the spleen is large and the lesion, especially the hyperemia, is exposed to the ribs, it is more likely to rupture. The incidence of spleen rupture such as abdominal blunt contusion and severe fall injury was the first. Often associated with liver rupture.

The spleen, which is enlarged due to illness, has a higher chance of rupture, and can be ruptured due to minor injury that is not noticed. It is called natural rupture of the spleen. Pathogenesis: It is difficult to close the healthy search after rupture of the spleen membrane, so it is easy to bleed. Not easy to stop. Internal hemorrhage is a prominent pathology, often caused by a large number of bleeding and shock. Because the spleen is thin, the connective tissue is lacking around the spleen. After the rupture, the blood flows into the free abdominal cavity. It is rare to retain the blood clot and the adhesion healing. Even if the bleeding is temporarily stopped, the possibility of hemorrhage is greater.

an examination

Related inspection

Abdominal plain electrocardiogram

Diagnosis: palpation in the left upper abdomen has tenderness and percussion dullness. The diagnosis is basically determined when the abdominal puncture is bloody. If the condition of the child is allowed to move, a B-ultrasound examination can show the shape and spleen of the spleen, and can estimate the amount of bleeding and the formation of hematoma, which is an important diagnostic method before surgery. The early stage of blood is basically normal, and obvious anemia can be seen after more than ten hours.

Because the rupture of the spleen is mostly part of a complex injury such as a fall or a bruise, a systematic systemic examination must be performed for each child, including: facial features, neck activity, chest auscultation, limb spine, and hematuria, at least after injury. Observe for 6h. If necessary, perform X-ray, CT, MRI, etc., for safe and rapid diagnosis. If it is considered that the spleen is naturally ruptured or the pathological spleen ruptures, the cause of splenomegaly needs to be further diagnosed in order to cure after hemostasis. Laparoscopy has little effect on the diagnosis and treatment of spleen rupture. It can be used instead of open exploration only when the amount of blood is not large, and it is observed for 3 days without progress in the abdominal sign.

Differential diagnosis

Painful mass can be seen in the lower left abdomen: can be seen in ulcerative colitis, rectum, sigmoid cancer. Rectal, sigmoid schistosomiasis granuloma, left oocysts and so on.

Abdominal stiffness: one of the clinical manifestations of acute appendicitis. The onset of acute appendicitis is often upper abdominal pain or full abdominal pain, which is gradually limited to Markov's point. The nausea and vomiting are more prominent, and the tenderness, rebound tenderness and abdominal muscle rigidity are more obvious. Acute appendicitis is the first place in various surgical acute diseases. In 1886, Fitz was first named. In 1889, McBurney proposed the surgical treatment of this disease. Over the past century, due to the improvement of surgical techniques, anesthesia and antibiotic treatment and nursing, the vast majority of patients have been cured, and the mortality rate has dropped to about 0.1%. Sexual right lower abdominal pain and appendical tenderness and rebound tenderness are common clinical manifestations, but the condition of acute appendicitis is so varied that it should be taken seriously for each specific case. Detailed medical history should be examined carefully, so that accurate diagnosis and early surgery can be performed. Prevent complications and increase cure rate.

Left lower abdominal pain: Left lower abdominal pain with abdominal pain and diarrhea may be colitis. Colitis abdominal pain is usually pain or cramping, often located in the left lower abdomen or lower abdomen. Other manifestations include loss of appetite, bloating, nausea, vomiting, and large liver. The left lower abdomen may have tenderness and sometimes reach the colon of the sputum. Left lower abdominal pain is generally a problem of the sigmoid colon, left ovary and fallopian tubes, left ureter.

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