abdominal bleeding
Introduction
Introduction Lesions of various organs in the abdominal cavity damage the rupture of the blood vessels and can cause abdominal bleeding. Abdominal hemorrhage is usually caused by rupture of the parenchymal organs, the most common is rupture of the spleen, followed by liver rupture. Bloody peritonitis can occur after bleeding, and the symptoms are mild. The patient is generally in poor condition and has low blood pressure and may have symptoms of shock. Pay attention to check whether the combined cavity is ruptured, and a plain X-ray film is necessary. Suddenly fainted, it is a manifestation of hemorrhagic shock. Sometimes it will be sprayed or spilled from the mouth, nose and other parts. If the situation is critical, you should go to the hospital as soon as possible.
Cause
Cause
Causes
Abdominal hemorrhage is usually caused by rupture of the parenchymal organs, the most common is rupture of the spleen, followed by liver rupture. Bloody peritonitis can occur after bleeding, and the symptoms are mild. The patient is generally in poor condition and has low blood pressure and may have symptoms of shock. The lesions of various organs in the abdominal cavity can damage the blood vessels and cause abdominal bleeding, which has serious consequences, such as:
1. In severe acute appendicitis, the mesangium is hypertrophic due to inflammatory edema. When the mesangial blood vessels are ligated, the fragile edema tissue is easily broken, resulting in weak blood vessel ligation. Or the mesangial is crushed when the jaws are clamped, and the blood vessels are not tied when ligated.
2. The vascular clamp of the clamped mesial is loosened, the blood vessel is retracted, and the jaw is clamped again. When the ligation is performed, the blood vessel is not clamped and tied.
3. When ligating the mesentery, the surgeon should gradually tighten the ligature under the vascular clamp, and the assistant should gradually relax the vascular clamp. If the assistant puts the forceps too fast, the blood vessel retracts and is not tightened. The vascular end of the vascular end was not bleeding due to the compression of the vascular clamp, and the lumen gradually opened and hemorrhage.
4. In the appendectomy, the branch of the appendix artery is not ligated, the patient may not be bleeding due to low blood pressure, and hemorrhage occurs again after the blood pressure rises after surgery.
5. Ligation is not secure, causing the ligature to loosen and bleed.
6. Due to inflammatory corrosion or abdominal drainage tube placed too long or hard texture, compression of nearby tissues and blood vessels caused bleeding. The incidence of such bleeding is extremely low and the amount of bleeding is also low.
Examine
an examination
Related inspection
Abdominal plain film urinary fibrin degradation products
Clinical manifestation
Pay attention to check whether the combined cavity is ruptured, and a plain X-ray film is necessary. If there is free gas in the abdomen, or peritonitis is obvious, it is suspected that there is a rupture of the cavity. It is feasible to diagnose abdominal puncture, and the nature of the perforation can judge the damage of the organ. After anti-shock, it is quickly pushed into the operating room. The rupture of the spleen needs to be removed. The liver rupture depends on the specific situation. Other combined injuries should also be considered in specific situations. Intra-abdominal hemorrhage needs to pay attention to the retroperitoneal hemorrhage, which is usually caused by pelvic fracture, and the onset is concealed, which is extremely harmful. Patients with pelvic fractures have reduced blood pressure, shock and other symptoms, and should be highly suspected of retroperitoneal hematoma.
Diagnosis
Differential diagnosis
Symptoms of abdominal hemorrhage include hemorrhagic shock, severe abdominal pain, and abdominal puncture can extract blood that does not coagulate, and need to be distinguished from the following symptoms.
Gastrointestinal bleeding: Many lesions in the digestive tract can bleed, but most can be explained by a few disease diagnoses. The difference between upper and lower gastrointestinal bleeding depends on its proximal or distal end of the Treitz ligament.
Ectopic pregnancy: the implantation of a pregnant egg outside the uterus is called an ectopic pregnancy, commonly known as ectopic pregnancy. Ectopic pregnancy can occur in the fallopian tube, ovary, abdominal cavity, broad ligament, etc., of which tubal pregnancy is the most common, accounting for about 90% to 95% of the incidence.
Luteal rupture: rupture of the corpus luteum is one of the common acute abdomen diseases in gynecology. It occurs in young women between the ages of 14 and 30. Therefore, some people call it "young killer."
Abdominal implantation: When cancer cells invade the serosa, they can fall off the surface of other organs in the abdominal cavity, causing the abdominal cavity to spread. Abdominal implant metastasis is a complex biological process. The most common sites are omentum, mesenteric, bladder rectal recess, uterine rectal recess, etc., which are more common in the pelvic Douglas nest (rectal uterus depression); Induration, can also be widely planted in the abdominal cavity to form cancerous peritonitis.
Abdominal hemorrhage: The abdominal organ ruptures under the disease of its own disease or external force, and the blood in the abdominal cavity can be confirmed as hemorrhage. The liver is the largest substantial organ in the abdominal cavity and carries important physiological functions of the human body. Hepatocytes are poorly tolerant to hypoxia, so hepatic arteries and portal veins provide a rich blood supply, and large and small bile ducts and blood vessels accompany bile. It is located deep in the right upper abdomen and has protection from the lower chest wall and diaphragm. However, due to the large size of the liver and the fragility of the liver, intra-abdominal hemorrhage or bile leakage may occur if it is easily damaged by violence.
