BACKGROUND: Intra-abdominal free fluid is commonly caused by injuries of solid or hollow organs in patients suffering from blunt abdominal trauma (BAT). However, it presents a diagnostic dilemma for surgeons when free...BACKGROUND: Intra-abdominal free fluid is commonly caused by injuries of solid or hollow organs in patients suffering from blunt abdominal trauma (BAT). However, it presents a diagnostic dilemma for surgeons when free fluid is unexplained, especially in stable BAT patients. This study was to analyze the incidence of such unexplained free fluid in BAT patients and its diagnostic value in abdominal organ injury. METHODS: Altogether 597 patients with BAT who had been treated at our trauma center over a 10-year period were reviewed. Stable patients with free fluid but without free air or definite organ injury on abdominal computed tomography were studied. Clinical management and operative findings were analyzed. RESULTS: Thirty-four (5.70%) of the 597 patients met the inclusion criteria: 24 (4.02%) underwent therapeutic exploratory laparotomy: bowel injuries were found in 13, hepatic rupture in 3, colon rupture in 3, duodenal rupture in 2, spleen rupture in 1, pancreas rupture in 1, and gallbladder perforation in 1. In 2 patients, laparotomy was nontherapeutic. Those with moderate or large amounts of free fluid were more likely to suffer from a hollow viscus injury and have a therapeutic procedure. The mean time of hospital stay for the delayed laparotomy group was longer than that for the emergency group (19 5.12 vs. 12 2.24 days; t=2.73, P<0.01). CONCLUSIONS: There was a positive correlation between the amount of unexplained free fluid and the determination of intra-abdominal organ injury. The proportion of BAT patients who required surgical intervention was high, particularly those with a moderate or large amount of free fluid, and most of them suffered from a hollow organ injury. Emergency laparotomy is recommended for these patients.展开更多
A boundary element method for simulating thermocapillary convection in a two-layer immiscible fluid system with flat and free interface has been developed.The divergence theorem is applied to the non-linear convective...A boundary element method for simulating thermocapillary convection in a two-layer immiscible fluid system with flat and free interface has been developed.The divergence theorem is applied to the non-linear convective volume integral of the boundary element formulation with the pressure penalty function.Consequently,velocity gradients are eliminated and the complete formulation is written in terms of velocity.This avoids the difficulty of convective discretizations and provides considerable reductions in storage and computational requirements while improving accuracy.In this paper,we give the influence of different parameters(Marangoni number, Reynolds number)on thermocapillary convection in cavity with two-layer immiscible fluids.As shown by the numerical results,when the physical parameters between liquid encapsulant and melt are chosen appropriately, the detrimental flow in the bottom melt layer can be greatly suppressed.The influence of the free interface on thermocapillary convection is also shown.展开更多
基金supported by grants from the National Natural Science Foundation of China(No.30801188)the Natural Science Foundation of Zhejiang Province,China(No.Y2090443 and No.Y2090460)
文摘BACKGROUND: Intra-abdominal free fluid is commonly caused by injuries of solid or hollow organs in patients suffering from blunt abdominal trauma (BAT). However, it presents a diagnostic dilemma for surgeons when free fluid is unexplained, especially in stable BAT patients. This study was to analyze the incidence of such unexplained free fluid in BAT patients and its diagnostic value in abdominal organ injury. METHODS: Altogether 597 patients with BAT who had been treated at our trauma center over a 10-year period were reviewed. Stable patients with free fluid but without free air or definite organ injury on abdominal computed tomography were studied. Clinical management and operative findings were analyzed. RESULTS: Thirty-four (5.70%) of the 597 patients met the inclusion criteria: 24 (4.02%) underwent therapeutic exploratory laparotomy: bowel injuries were found in 13, hepatic rupture in 3, colon rupture in 3, duodenal rupture in 2, spleen rupture in 1, pancreas rupture in 1, and gallbladder perforation in 1. In 2 patients, laparotomy was nontherapeutic. Those with moderate or large amounts of free fluid were more likely to suffer from a hollow viscus injury and have a therapeutic procedure. The mean time of hospital stay for the delayed laparotomy group was longer than that for the emergency group (19 5.12 vs. 12 2.24 days; t=2.73, P<0.01). CONCLUSIONS: There was a positive correlation between the amount of unexplained free fluid and the determination of intra-abdominal organ injury. The proportion of BAT patients who required surgical intervention was high, particularly those with a moderate or large amount of free fluid, and most of them suffered from a hollow organ injury. Emergency laparotomy is recommended for these patients.
基金Project supported by the National Natural Science Foundation of China
文摘A boundary element method for simulating thermocapillary convection in a two-layer immiscible fluid system with flat and free interface has been developed.The divergence theorem is applied to the non-linear convective volume integral of the boundary element formulation with the pressure penalty function.Consequently,velocity gradients are eliminated and the complete formulation is written in terms of velocity.This avoids the difficulty of convective discretizations and provides considerable reductions in storage and computational requirements while improving accuracy.In this paper,we give the influence of different parameters(Marangoni number, Reynolds number)on thermocapillary convection in cavity with two-layer immiscible fluids.As shown by the numerical results,when the physical parameters between liquid encapsulant and melt are chosen appropriately, the detrimental flow in the bottom melt layer can be greatly suppressed.The influence of the free interface on thermocapillary convection is also shown.
