Felipe Vega Rivera, Juan Carlos Millán, Mario Castillo Jiménez, Gerardo Larrinúa Regalado, Ivonne Zamudio Enciso, Juan Carlos Vázquez Minero, Víctor Hugo Serna, Delgadillo GS, Martínez AF

Language: Spanish
References: 28
Page: 103-109
PDF size: 91.52 Kb.

ABSTRACT

Abdominal sepsis as a result of trauma is estimated to cause mortality in the critical care unit in 80% of patients in a productive age. We took the concept of septic abdomen as a large- scale abscess and we utilized the sterile urine-collecting bag for its management in the open abdomen. Objective: To show our institution’s experience in the management of abdominal sepsis caused by trauma and determine factors associated that increase mortality. Material and methods: Two years of data from hospitalized patients with abdominal sepsis as a result of trauma was collected. Age, gender, associated injuries, mortality and postoperative complications were collected. The treatment consisted of open abdomen and repeated surgical lavage. Results: From the 22 patients 68% ranged between the ages of 15 and 34 years. Penetrating mechanism was predominant with 73% mainly from firearms. We obtained a survival of 60%, increasing mortality in colon, liver and associated small bowel injuries (contaminating triad). The majority of patients were closed definitively at the second week. The complete postoperative recovery was two months, with existing complications such as wall abscess 31% and postoperative pancreatitis 5%. Discussion: Mortality duo to sepsis secondary to trauma is high in the international literature. The decision to treat patients with open abdomen is a challenge and should be the first choice in the presence of the “contaminating triad”. Conclusions: This type of aggressive treatment reduced mortality at our institution allowing a continuous assessment of the intra-abdominal conditions.

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