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Biomedical subjects

C G Bitondo

Publications and source records attributed to C G Bitondo.

21 records · Page 2Linked to original sources

Five hundred open taps or lavages in patients with abdominal stab wounds.

From 1980 to 1984, 500 asymptomatic patients with anterior abdominal stab wounds found to have penetrated the anterior peritoneal cavity on local wound exploration in the emergency center were evaluated by the technique of open peritoneal tap, quantitative diagnostic peritoneal lavage, or both. The technique was found to have several advantages, including earlier diagnosis of intraperitoneal visceral injuries in asymptomatic patients and a significant lowering of the incidence of unnecessary celiotomies in a busy county hospital. Also, it was extremely cost-effective. The major disadvantages were the number of false-positive results of taps and lavages based on red blood cell counts of more than 100,000/mm3, all of which resulted from bleeding from abdominal wall stab wound sites. An accuracy rate of approximately 91 percent was maintained throughout the period of the study, whereas there were only 1.8 false-negative results of lavage per year. Local wound exploration coupled with open peritoneal tap and diagnostic peritoneal lavage is recommended as a rapid, safe, and cost-effective technique for the evaluation of large numbers of asymptomatic patients who present with anterior abdominal stab wounds.

Abdominal Injuries↗

Civilian trauma in the 1980s. A 1-year experience with 456 vascular and cardiac injuries.

During 1982, 312 patients with 408 vascular injuries and 48 cardiac injuries were seen. Two or more vascular or cardiac injuries were present in 34% of patients. Over 87% of injuries were secondary to gunshot wounds, stab wounds, or shotgun wounds. Vascular injuries were most commonly seen in the extremities (39.9%) or abdomen (31.9%). The most common arterial injuries occurred in the brachial artery (39 patients), while the most common venous injuries occurred in the internal jugular vein (26 patients). Arterial injuries were treated by the insertion of substitute vascular conduits (33.9%), ligation (22.6%), lateral arteriorrhaphy (18.6%), or end-to-end anastomosis (15.4%). Venous injuries were treated by lateral venorrhaphy (63.7%) or ligation (25.1%). In the 272 patients admitted with only vascular injuries, survival was 84.2%. Cardiac injuries in 38 patients most commonly occurred in the right ventricle (50%) and right atrium (25%). In the 34 patients who had only cardiac injuries and less than 4 minutes of prehospital cardiopulmonary arrest prior to arrival in the emergency center, survival was 64.7%.

Adult↗

Bilateral external iliac artery injury from a single missile.

Bilateral vascular injuries either from penetrating or blunt trauma are rare. This report of a patient with injury to both external iliac arteries stresses the need for early operation in abdominal vascular trauma, the occasional need for groin incisions to obtain distal vascular control and the advantages of prosthetic replacement when extensive injuries are present in large vessels.

Adult↗