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W L Abrantes

Publications and source records attributed to W L Abrantes.

11 recordsLinked to original sources
PubMed2001

Blunt gastric injury. A multicentre experience.

A multicentre retrospective analysis of blunt gastric injuries from four trauma centres in Brazil was performed. From January 1982 to May 1996, 33 patients were found to have blunt gastric injury: 26 were male and the mean age was 26.2 years. The most frequent mechanism of injury was automobile versus pedestrian (17) followed by motor vehicle accidents (seven). Abdominal pain was the most common finding (29) and peritoneal signs were present in 14. There were 21 grade I, seven grade II, four grade III and one grade IV blunt gastric injuries. Simple suture was the treatment of choice in 24 patients, eight required no treatment, and only one patient underwent gastric resection. The liver and spleen were the most commonly associated injured organs. Two patients had isolated gastric injury. There were two gastric fistulae and both patients died. Overall morbidity and mortality was 12 (36%) and nine (27%), respectively. The ISS was higher in the non-survivor group (P=0.03) and the gastric organ injury score did not reach statistical significance when comparing survivors and non-survivors. We conclude that blunt gastric injury is uncommon and is associated with other injuries of greater magnitude, which generally influence mortality.

Abdominal Injuries↗
PubMedDate not supplied

Sonographic features of portal hypertension in schistosomiasis mansoni.

The diagnostic value of real-time sonography in the study of portal hypertension was assessed in 66 patients with hepatosplenic schistosomiasis mansoni, all with Symmers's fibrosis and esophageal varices. Seventy-one individuals without schistosomiasis were selected as controls. The inner diameters of the portal vessels were measured by sonography in all patients and controls: splenoportography was also performed in the schistosomal group. Intra-splenic pressure was over 30 cm of water in 44 of 60 patients with schistosomiasis. The upper limit of normality for portal vessel diameters was set through receiver operating characteristic curve at 12 mm for portal vein, 9 mm for splenic vein at splenic hilus, and 9 mm for superior mesenteric vein. The best discriminative vein for the diagnosis of portal hypertension was the splenic vein followed by the portal vein. A direct correlation was observed between the diameter of the splenic vein, measured by sonography, and the intra-splenic pressure. Except for the paraumbilical and mesenteric veins, more frequently identified by sonography, there was no statistical difference in the frequency of visualization of splanchnic vessels by sonography or splenoportography.

Adolescent↗
PubMedDate not supplied

[Conservative surgery of splenic trauma in children].

The spleen is an important component of the immunologic system, especially in children. Splenectomy may result in immunologic deficiency, and splenic salvage is recommended as management in splenic surgery. PURPOSE--Splenic injury management, considering splenic salvage as a safe therapeutic option in these children. METHODS--One hundred and thirty nine (139) children, aged 5 months to 12 years were at João XXIII Hospital, Belo Horizonte, Brazil, for the period of 1981 to 1990. The causes of the trauma, the extent and the management of splenic injuries were evaluated. Hemodynamic instability with shock occurred in 30% of the children. The contusions were responsible for injury in 135 patients (97.2%) with 58.7% caused by pedestrian/motor vehicle accidents 41.6% of splenic injury were grade I and II, 30.6% were grade III, and 26.5 grade IV e V (Injury Scalling Committee). RESULTS--Non operative management was done in 2 patients and 137 were operated on. Conservative surgery was performed in 98 patients (71.5%), which included: splenorraphy in 81 (82.6); partial splenectomy in 10 (10.2%), and laparotomy followed by observation in 7 (7.1%). Post-surgical hemorrhage occurred in one case after conservative surgery. Splenectomy was performed in 39 (28.5%) of the patients with 75-100% of the splenic injury classified in grades IV and V. Multiple associated lesions occurred in 87 children (62.5%). The mortality rate was 10.5%. Cranioencephalic trauma was the cause of death in 13 children. CONCLUSION--The splenic salvage is a possible option in the management of splenic injury in 70% of the cases. Nonoperative treatment of splenic injury depends on the physiologic status of the patient, CT scan demonstration of splenic injury and intensive care management. If there was an associated abdominal injury, there would be an indication for surgery.

Child↗