PubMed · 5061132
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1972-02-19. Multiple trauma.. https://pubmed.ncbi.nlm.nih.gov/5061132/
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Twenty-two horses were examined because of firearm injuries. Nine had been shot with .22-caliber bullets, 2 with BB pellets, 6 with buckshot, 1 with a .35-caliber bullet, and 1 with an airgun pellet. Injury was confined to the skin or skeletal muscles in 8 horses. Of these, 7 returned to their previous use. In 14 horses, injuries to additional structures were incurred, including the sinus and pharynx (n = 2), mandible (n = 1), tooth (n = 1), aorta (n = 1), eye (n = 3), tibia (n = 1), gastrointestinal tract (n = 3), joint (n = 1), and trachea (n = 1). The 3 horses that had only eye injuries were discharged to their owners. Of the other 11 horses with injuries to deep/vital structures, 3 died, 5 were euthanatized, and 3 survived.
A 27-year-old female patient presented in our clinic 14 hours after onset of acute lower abdominal pain during sexual intercourse. Sonography showed ascites around the uterus and structures suspected to be clotted blood. Diagnostic laparoscopy showed in the abdomen about 400 ml of clotted blood: sources of bleeding were small injuries of the left sacro-uterine ligament. Therapy was not necessary, except careful rinsing since hemostasis was already complete. It is important to consider abdominal injuries in cases of abdominal pain after sexual intercourse, even if vulvar or vaginal injuries are absent.
Over the past decade CT scanning has become generally accepted in North America as the diagnostic modality of choice for the evaluation of abdominal injury in children following blunt trauma [1-5]. Recently, there has been increasing interest in the use of sonography as the primary screening examination in this area. Initial studies utilizing sonography in the evaluation of trauma patients focused primarily on identifying hemoperitoneum in adults [6-8]. More recent studies have also attempted to evaluate the accuracy of sonography for the diagnosis of solid viscus injury [9-14]. Filiatraut and colleagues recently reported a long and successful experience using sonography for the investigation of blunt abdominal trauma in children [12]. Their work in this area should be applauded. However, whether widespread application of this modality can be successful remains uncertain. In the space below a critical evaluation of sonography and CT in the assessment of injured children is presented.