Liver dullness circle shrinks or disappears
Introduction
Introduction The clinical diagnosis of closed abdominal injury may include tenderness, rebound tenderness, and muscle tension in the abdomen. There may be mobility dullness, reduced or disappeared liver dullness, and weakened or disappeared bowel sounds. Closed abdominal injuries are common in production, transportation, and life accidents. The patient's prognosis depends on the presence or absence of visceral injury, often accompanied by other parts of the injury, such as brain trauma, chest trauma and fractures, covering up the history and signs, making the diagnosis difficult to identify, and because of some minor damage, There may be intra-abdominal organ damage.
Cause
Cause
The causes of liver dullness shrinking or disappearing are:
1. The disappearance of liver dullness is mainly seen in severe hepatitis. Due to liver failure, a large number of hepatocytes are necrotic, and the liver is progressively reduced, resulting in the disappearance of the liver dullness.
2, a large amount of ascites or right pleural effusion, seriously affecting the percussion, can also lead to the disappearance of the pseudo-heavy liver dullness.
3, the surface of the liver is covered with free gas, causing the percussion sound to become drum sound, such as gastrointestinal perforation.
Examine
an examination
Related inspection
Liver and gallbladder percussion liver function test liver upper and lower boundary percussion liver ultrasound liver palpation
Clinical manifestation
1. Persistent abdominal pain, nausea, vomiting is often a general manifestation of intra-abdominal organ injury.
2. Peritoneal irritation, mobile dullness, weakened or disappeared bowel sounds are important signs of intra-abdominal organ injury, the most obvious signs, often the damage.
3. Substantial organ damage, mainly the manifestations of internal bleeding, such as pale skin, pale pulse, decreased blood pressure, blood pressure, etc., and may be accompanied by peritoneal irritation.
4. The rupture of the hollow organ is mainly the manifestation of peritonitis, with strong peritoneal irritation.
Diagnosis
Differential diagnosis
Should be combined with the clinical diagnosis of closed abdominal injury, the presence of tenderness, rebound tenderness, muscle tension in the abdomen, and the symptoms of mobile dullness can be diagnosed and differentiated.
Diagnose based on
1. The abdomen has a history of direct or indirect violent injuries.
2. Often have obvious abdominal pain, accompanied by nausea and vomiting. Shock symptoms can occur.
3. The abdomen may have tenderness, rebound tenderness, muscle tension, and may have a mobile dullness. The liver dullness is reduced or disappeared, and the bowel sounds are weakened or disappeared.
4. X-ray examination, there may be free gas under the armpit.
5. Positive results were obtained by diagnostic abdominal puncture or peritoneal lavage.
6. B-mode ultrasound, CT, or MR examination, can be diagnosed for substantial organ injury.
7. Celiac angiography, intra-abdominal hemorrhage has a positive result.
8. Exploratory diagnosis by laparotomy.
