事件记录
面试官: Your young athlete was playing soccer or football and took a hit to the midsection in the front. And now the upper left-hand side of the abdominal area is hurting. 会不会是脾脏的问题? 如果是，你应该怎么做? Dr. 特洛伊马德森 is an emergency room physician at University of Utah Health Care. So in that scenario, if that happens, what's the first step?
Spleen Injuries are a Serious Concern
Dr. 马德森: It's kind of like this scenario you described, I think the most likely thing you're going to see with this potential injury, 脾损伤, is maybe you've got a kid that plays high school football, or you've got a young kid that plays soccer, 或者其他. 也许他们只是在课间休息, and your kid comes home and they said they got hit in the belly, and they're hurting in the left upper side of their abdomen. Well, that's right where the spleen is, the left upper side of the abdomen.
The concern there is the spleen is an organ that is very prone to injury, 它可能会受伤, 它会撕裂, 那里的血管会撕裂. And there's so much blood that runs through that organ that if it tears, 如果开始出血, the person can bleed out really quickly, and it can be a life-threatening injury.
面试官: So that's a big deal if you have somebody complaining about it. So probably you don't want to think about it too much.
Dr. 马德森: 你不. It's one of those things if you've got a kid who's 说ing, “我受到伤害了, 这就是痛的地方," and it's the left upper side of the abdomen, “我在大发娱乐被击中了.“他们真的需要去急诊室, because I have actually seen cases of people who have died from spleen injuries, 那些有过, 不管出于什么原因, 车祸, 或者他们在那里被击中, spleen ruptures and it bleeds out very quickly, and they lose all that blood into their abdomen.
Spleen Injury Symptoms and Treatment Options
面试官: Is it a different kind of pain than just getting hit in the gut pain?
Dr. 马德森: You know, getting hit in the gut, we've all experienced that. 它让你无法呼吸. I would expect that to get better within maybe 10 to 15 minutes. Spleen injuries, you're going to continue to have pain there.
面试官: 好吧.
Dr. 马德森: 你会感觉到的. And then one of the other things that often people have with spleen injuries is their shoulder hurts too. 挺有趣的. That irritates the bottom part of the lungs, 隔膜, and the neck can cause that pain to radiate up to the left shoulder, plus kind of one of the classic textbook things for 脾损伤, 也有值得注意的地方. 但, 你知道, 如果你来急诊室, the first thing I'm going to do is an ultrasound, 看看你的腹部, 看看能否看到腹部有血, 取决于我在那里看到了什么, I may be calling a surgeon to come down and take a look at you. 或者大发娱乐得做个CAT扫描. 但实际上, you need to have something done to look at the spleen, 说, "Is this injured and is this something that needs to be repaired surgically?"
面试官: 疼得很厉害吗?
Dr. 马德森: 可以是.
面试官: 所以它可能不是.
Dr. 马德森: I mean, I would 说 it's at least moderate pain. If you've just got some mild surface pain from some bruising on the skin. This is going to be a deeper sort of pain, 至少会有轻微的疼痛, 也许会有点头晕, maybe with that shoulder pain I mentioned.
面试官: 让你.
Dr. 马德森: 这是某种组合. 你不 need to rush in just for maybe some muscle tightness and something that hit the abs and caused some bruising on the muscles there. 但这将是更深的痛苦, 它可能会直通到后面, and it may have some pain going up through there as well.
Seeking Immediate Medical Attention for Spleen Injury
面试官: Because I think this is one of those situations where, 作为家长, 你像, “哇, I don't want to go to the ER if I don't have to, so.听起来是这样, 男人。, 如果它在里面, 如果那个部位疼痛, 千万别冒这个险.
Dr. 马德森: 对我来说, 是的, it's one of those things that if your kid is coming to you and just 说ing, “嘿, 妈妈,或者爸爸, 或者谁, “我的肚子真的很痛.“这可能已经足够令人担忧了. If they 说, "My belly is really hurting. 我被击中了." It's not like you're just seeing the kid get hit on the field and 说, "Oh, do you hurt there?“哦，是的，我有点疼。." They're coming to you describing this pain. 对我来说，这已经足够令人担忧了. 他们需要检查一下.
面试官: So if you were to have somebody in your family or life call you and 说, “嘿, Dr. 马森, 我儿子在踢足球, kid collided right into his stomach head on, 已经好几个小时了. Now he's 说ing the upper left side of his abdominal area hurts.“你会对他们说什么？?
Dr. 马德森: 我会告诉他们，“去急诊室. 你得去检查一下.“这很有趣, I find that most family members who call me about the ER want me to tell them, “不要去急诊室," even when they know they probably should. This is a case where I think you'd probably be thinking, "I probably need to go to the ER.“你说得很对.
更新日期：2023年9月28日
originally published: February 3, 2017