medigraphic.com
ISSN 2007-6517 (Print)

2013, Number 1

<< Back Next >>

Rev Latinoam Cir 2013; 3 (1)

Blunt and penetrating abdominal trauma with injury to intra-abdominal organs

Leonher RKL, Jiménez GJA, Ramírez GLR, Sandoval SM, Gil VJJ, Tello BIM

Language: Spanish
References: 29
Page: 20-24
PDF size: 220.84 Kb.


ABSTRACT

Introduction: The target organ injuries have high mortality. The purpose of this study was to identify the incidence of organ injury in patients treated for abdominal trauma and thereby assess the diagnostic and management given.
Material and methods: In this study, we reviewed all patients with polytrauma underwent exploratory laparotomy in a period of two years. The variables investigated were: gender, age, mechanism of injury, diagnostic method, clinical diagnosis, most affected organ, hospital stay, morbidity and mortality.
Results: 53 patients were admitted, 75.5 % male (N =40) and 24.5 % female (N =13), the average age was 34.96 years (19-60 years). The predominant mechanism of injury was blunt abdominal trauma in 50.9 % (N=27) with penetrating abdominal trauma stab represent 26.4 % (N = 14), and penetrating abdominal trauma gunshot was 22.6 % (N=12). The diagnostic method used was CT in 71.1 % (N=38) in 20.8 % passage to surgery without previous imaging studies. The body was mostly injured spleen by 24.5 % (N=13) liver injury in 13.4 % (N=7). The average hospital stay was 8.57 days (1-25 days). The mortality rate was 13.2 % (N =7).
Conclusion: Patients with multiple injuries in critical condition generally arrive so fast approach is indispensable. Morbidity and mortality are at stake and depend on proper operation, this in turn implies a diagnosis and early and appropriate surgical approach according to the mechanism of injury.


REFERENCES

  1. Cornwell EE III, Velmahos GC, Berne TV et al. Lethal abdominal gunshot wounds at a Level I trauma center: Analysis of TRISS (Revised Trauma Score and Injury Severity Score) fallouts. J Am Coll Surg. 1998;187:123.

  2. Balogh Z, Offner P, Moore EE et al. NISS predicts postinjury organ failure better than the ISS. J Trauma. 2000;48:624.

  3. Moore EE, Dunn EL, Moore JB et al. Penetrating abdominal trauma index. J Trauma. 1981;21:439.

  4. Sikic N, Korac Z, Krajacic I et al. War abdominal trauma: usefulness of penetrating abdominal trauma index, injury severity score, and number of abdominal organs injured. Milit Med. 2001;166:226.

  5. Pacheco FAM. Abdominal trauma. Rev Med Clin Condes. 201;5:623-630.

  6. Malhotra AK, Fabian TC, Katsis SB et al. Blunt bowel and mesenteric injuries: The role of screening computed tomography. J Trauma. 2000;48:991.

  7. Rozycki GS, Ballard RB, Feliciano D et al.: Surgeon-performed ultrasound for the assessment of truncal injuries: Lessons learned from 1,540 patients. Ann Surg. 1998;228:557.

  8. Starnes S, Klein P, Magagna L et al. Computed tomographic grading is useful in the selection of patients for nonoperative management of blunt injury to the spleen. Am Surg. 1998;64:743.

  9. Frick EJ Jr, Pasquale MD, Cipolle MD et al. Small bowel and mesenteric injuries in blunt trauma. J Trauma. 1999;46:920.

  10. Shankar KR, Lloyd DA, Kitteringham L et al. Oral contrast with computed tomography in the evaluation of blunt abdominal trauma in children. Br J Surg. 1999;86:1073.

  11. Shaftan GW. Indications for operation in abdominal trauma. Am J Surg. 1960;99:657.

  12. Udobi KF, Rodriguez A, Chiu WC et al. Role of ultrasonography in penetrating abdominal trauma: A prospective clinical study. J Trauma. 2001;50:475.

  13. Cunningham MA, Tyroch AH, Kaups KL et al. Does free fluid on abdominal computed tomographic scan after blunt trauma require laparotomy? J Trauma. 1998;44:599.

  14. Beierle EA, Chen MK, Whalen TV et al. Free fluid on abdominal computed tomography scan after blunt trauma does not mandate exploratory laparotomy in children. J Ped Surg. 2000;35:990.

  15. Stafford RE, McGonigal MD, Weigelt JA et al. Oral contrast solution and computed tomography for blunt abdominal trauma: A randomized study. Arch Surg. 1999;134:622.

  16. Patel JC, Tepas JJ. The efficacy of focused abdominal sonography for trauma (FAST) as a screening tool in the assessment of injured children. J Pediat Surg. 1999;34:44.

  17. Root HD, Hauser CW, McKinley CR et al. Diagnostic peritoneal lavage. Surgery. 1965;57:633.

  18. Merlotti GJ, Marcet E, Sheaff CM et al. Use of peritoneal lavage to evaluate abdominal penetration. J Trauma. 1985;25:228.

  19. Velmahos GC, Demetriades D, Cornwell EE III et al. Gunshot wounds to the buttocks: Predicting the need for operation. Dis Colon Rec. 1997;40:307.

  20. Velmahos GC, Gomez H, Falabella A et al. Operative management of civilian rectal gunshot wounds: Simpler is better. World J Surg. 2000;24:114.

  21. Villavicencio RT, Aucar JA. Analysis of laparoscopy in trauma. J Am Coll Surg. 1999;189:11.

  22. Murray JA, Demetriades D, Cornwell EE III et al. Penetrating left thoracoabdominal trauma: The incidence and clinical presentation of diaphragm injuries. J Trauma. 1997;43:624.

  23. Murray JA, Demetriades D, Asensio J et al. Occult injuries to the diaphragm: Prospective evaluation of laparoscopy in penetrating injuries to the left lower chest. J Am Coll Surg. 1998;187:626.

  24. Renz BM, Feliciano DV. Unnecessary laparotomies for trauma: A prospective study of morbidity. J Trauma. 1995;38:350.

  25. Velmahos GC, Demetriades D, Cornwell EE III et al. Selective management of renal gunshot wounds. Br J Surg. 1998;85:1121.

  26. Granson MA, Donovan AJ. Abdominal stab wound with omental evisceration. Arch Surg. 1983;118:57.

  27. Shah R, Max MH, Flint LM Jr et al. Negative laparotomy: mortality and morbidity among 100 patients. Am Surg. 1978;44:150.

  28. Demetriades D, Gomez H, Chahwan S et al. Gunshot injuries to the liver. The role of selective nonoperative management. J Am Coll Surg. 1999;188:343.

  29. Pachter HL, Hofstetter SR. The current status of nonoperative management of adult blunt hepatic injuries. Am J Surg. 1995;169:442.




2020     |     www.medigraphic.com