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At least 271 records · Page 15Linked to original sources
PubMed1997

Conservative management of abdominal injuries: audit of criteria for discharge.

This prospective study was conducted to audit the discharge criteria of patients admitted for the conservative management of abdominal trauma. A total of 184 patients who were admitted to Groote Schuur Hospital (GSH) with penetrating or blunt abdominal injuries and who were conservatively managed according to the GSH protocol were assessed. The study concluded that patients with abdominal trauma who do not require emergency laparotomy can be safely discharged after a period of conservative management provided they are pain-free, hungry and passing flatus.

Abdominal Injuries↗
PubMed1987

Triple-contrast computed tomography in the evaluation of penetrating posterior abdominal injuries.

Routine exploration of stable patients who have penetrating injuries of the posterior abdomen results in a high rate of unnecessary operation. Prolonged observation, while safe, is expensive and potentially morbid in the event that a retroperitoneal injury has occurred and treatment is delayed. To evaluate these injuries, we have developed and employed a protocol for computed tomographic (CT) scanning of the abdomen employing oral, intravenous, and rectal administration of contrast material to visualize the retroperitoneal contents. Between Jan 1, 1985, and Dec 1, 1986, 40 patients were studied in this manner. In each case, the path of penetration could be determined exactly by tracing the course of air and hematoma through the tissues. All retroperitoneal organs could be evaluated well enough to exclude injuries requiring intervention. The majority of patients showed subcutaneous penetrations only. All six significant intra-abdominal injuries were diagnosed correctly and confirmed at laparotomy. All 34 patients deemed by CT not to have significant injury were observed for 72 hours, and all were discharged uneventfully. Triple-contrast CT appears to be of great value in the triage of penetrating posterior abdominal trauma into operative and nonoperative groups.

Abdominal Injuries↗
PubMed1988

Thoraco-abdominal injuries in combat casualties on the Cambodian border.

This article deals with the experience in the management of combined thoraric and abdominal injuries caused by combat casualties, and is based on experience gained in the International Committee of the Red Cross (ICRC) hospital in Khao-I-Dang, Thailand. During a 3 month period a total of 123 patients injured by various battle conditions at the Thailand-Cambodian border were admitted to the ICRC hospital. The thorax was involved in 31 patients, but only 8 of these had a combination of thoracic and intra-abdominal lesions. Although many of the facilities and surgical instruments normally available in modern Western hospitals to deal with seriously injured patients were unavailable to us in field hospital conditions, our series shows that satisfactory results could be obtained even under such stressful and rudimentary conditions.

Abdominal Injuries↗
PubMed1994

Chest and abdominal injuries caused by seat belt loading.

Injuries will inevitably occur when restraining loads are exerted on a car occupant by a seat belt during a crash. This study investigated the nature, frequency, and severity of such injuries to the chest and abdomen. Vehicle, occupant, and injury details were obtained from accidents occurring in the Midlands of England. The sample was chosen with emphasis on fatal and serious injuries while also representing slight injuries as rated by the British government scheme. All causes of injuries to 3,276 front-seat restrained occupants were considered. 29.6% had a minor (Abbreviated Injury Scale [AIS] 1) injury caused by seat belt loading, more than from any other cause. The study went on to focus on 1,025 occupants sustaining injuries caused solely by seat belt loading. Of those, 19.4% sustained chest/abdominal injuries rated at Maximum AIS > or = 2 with sternum fractures predominating, and 4.5% were rated at Maximum AIS > or = 3. Occupants were not excluded if they had injuries at other body regions enabling the frequency and severity of head injuries to be considered also. The role played by impact type, speed change at impact, seat belt usage problems, and some aspects of occupant characteristics were investigated. While females were at much greater risk of serious injury (AIS > or = 3) when aged > or = 70 years, the effects of aging were more obvious in the cases with chest injuries rated at AIS 2. Serious chest injuries were predominantly a function of higher speed changes at impact. Occupant height and weight were shown to influence injury outcome, and the study concluded that work is required to further define occupants most at risk. Comparisons were made with two studies into other types of injury at other body regions, and injuries rated AIS > or = 2 caused by seat belt loading were seen to be relatively unlikely. It must also be stressed that casualties sustained seat belt injuries would most likely have received more severe injuries had a seat belt not been worn.

Abbreviated Injury Scale↗
PubMed1975

Renal trauma during laparotomy for intra-abdominal injury.

The advantages of nonsurgical or surgical management of renal injuries are important when the renal trauma is found during a laparotomy for intra-abdominal injury. Blunt external trauma caused 85.5 percent of the renal injuries found during laparotomy in 194 patients. A large dose or infusion intravenous pyelogram on a modified operating table has allowed immediate evaluation of the renal injury during a laparotomy. When the degree of renal injury was more severe, renal tissue and function were saved by early surgical management. In this group, lowered morbidity and a sharp reduction in delayed renal operations followed the introduction of immediate surgical management. The nephrectomy rate was 11 percent, which compares favorably with that of nonsurgical management. Clamping of the renal vessels prior to opening Gerota fascia prevented reactivation of hemorrhage and allowed for a deliberate operation with conservation of undamaged renal tissue.

Abdominal Injuries↗
PubMed1998

Effect of CT information on the diagnosis and management of acute abdominal injury in children.

PURPOSE: To evaluate the effect of computed tomographic (CT) information on diagnostic confidence and initial clinical treatment in children with abdominal trauma. MATERIALS AND METHODS: Senior surgical staff completed questionnaires before and after abdominal CT was performed in 138 consecutive children with acute abdominal trauma seen between April 1996 and April 1997. Physicians were asked to estimate the probability of underlying abdominal injury, which organ was injured, their level of confidence in the CT findings, and initial clinical management plans. The gain in percentage diagnostic confidence and the proportion of children in whom CT information changed diagnoses and initial management plans were evaluated. RESULTS: The CT findings changed the surgeons' initial diagnoses in 116 (84%) patients (95% confidence interval [CI] = 75%, 86%). The mean gain in diagnostic certainty with CT was 36% (95% CI = 31%, 40%). Initial management plans changed in 61 (44%) patients after CT information was available (95% CI = 35%, 50%). This resulted in decreased intensity of care in 52 (38%) patients and increased intensity of care in nine (6.5%). CONCLUSION: Abdominal CT had a strong effect on surgeons' clinical diagnoses and initial treatment plans in children with blunt trauma. CT information enabled surgeons to safely reduce the intensity of care provided to injured children.

Abdominal Injuries↗
PubMed1987

[Peritoneal lavage and blunt abdominal injuries in childhood].

Traffic accidents are increasingly responsible for mortality in childhood in Turkey. Between 1982 and 1984, 197 children were admitted for contused abdominal injuries to the surgical casualty ward at the School of Medicine of Istanbul University. Most of these children had been involved in traffic accidents, and peritoneal lavage was applied to all of them. The diagnosis on admission was confirmed by laparotomy in 90 per cent of all cases. 20 children died (10.1 per cent). Uncontrollable abdominal bleeding was the cause of ten deaths and massive brain lesion of another six.

Abdominal Injuries↗
PubMed1990

[Postoperative eventration in abdominal injuries].

In a work, the experience with treatment of 29 sufferers with abdominal traumas, who underwent relaparotomy for postoperative eventration, is analysed. Sudden soaking of a dressing by serous or serosanguineous fluid, abdominal pain, tachycardia, rising of a body temperature are the most informative symptoms permitting to establish the indications for relaparotomy in postoperative eventration.

Abdominal Injuries↗
PubMed1991

[Clinical analysis of abdominal injury complicated by disseminated intravascular coagulation].

Since there is no widely accepted diagnostic criterion for disseminated intravascular coagulation (DIC), We analyzed 25 cases of abdominal injury complicated by DIC and proposed the diagnostic criterion, the list of treatment and the correlation between clinical classification and pathological changes of traumatic DIC. At present, the correct diagnosis of DIC can only be established by analysing etiological factors, clinical symptoms and signs, results of experimental examination and effects of anticoagulation treatment. Timely and reasonable anticoagulation treatment is the key to reducing the mortality of DIC.

Abdominal Injuries↗
PubMed1984

Risk of infection following laparotomy for penetrating abdominal injury.

We analyzed the occurrence of putative risk factors for postoperative infection in 338 patients who underwent emergency laparotomy for penetrating abdominal injury. Mortality was 3%, with nine of ten deaths directly related to infectious complications. Gunshot wounds and colon injuries occurred more frequently in the patients who died than in survivors. Stepwise discriminant analysis revealed that transfusion requirement, length of operation, age, and the penetrating abdominal trauma index were the most significant risk factors for any infection. Other risk factors examined (shock, number of organs injured, mode of injury, and chest injury) did not contribute any additional information. Colon injury was more prevalent in patients with trauma-related infections than in those with nosocomial infections.

Abdominal Injuries↗
PubMed1990

The patient with abdominal injuries.

Pathology of blunt and penetrating abdominal trauma is presented in specific sections. Samples of a focused cue search, nursing diagnostic statements, and defining characteristics are included. Utilization of the aforementioned items are discussed within the context of a case involving victims of an accident resulting from a high-speed chase.

Abdominal Injuries↗
PubMed1981

[Ultrasonic diagnosis of blunt abdominal injuries].

In 190 patients with blunt abdominal trauma a sonogramm was made after admission. In 25 cases blood and fluid had accumulated in the abdominal cavity. In 24 cases diagnosis was correct. In patients who had organ lesions without fluid in the abdominal cavity the injured organ could be determined in 22 out of 25 cases. The danger of late liver and spleen ruptures existed in patients with organ hematomas. False positive results regarding fluid accumulation in the peritoneal cavity were found in 3 out of 165 patients.

Abdominal Injuries↗
PubMed1993

[The diagnosis and treatment of a closed abdominal injury]].

The experience with diagnosis and treatment of 216 sufferers with closed injury to the abdomen, including 186 who were operated on, has been summarized. The main methods for diagnosis of closed abdominal injury are laparoscopy and laparocentesis, the operation of choice--laparotomy.

Abdominal Injuries↗
PubMed2006

Abdominal injury patterns in real frontal crashes: influence of crash conditions, occupant seat and restraint systems.

An in-depth study was conducted through the analysis of medical reports and crash data from real world accidents. The objective was to investigate the abdominal injury patterns among car occupants in frontal crashes. The influence of the type of restraint system, the occupant seat, the age and the crash severity was investigated. The results indicate that the risk of abdominal AIS 3+ injuries increased with crash severity and decreased with the introduction of belt retractors. Rear belted passengers were observed to be more likely injured than front belted occupants. The organs injured in frontal crashes for belted occupants were mainly hollow organs especially jejunum, ileum and mesentery.

Abdominal Injuries↗
PubMed1980

Diagnosis of acute abdominal injuries in patients with spinal shock: value of diagnostic peritoneal lavage.

Loss of sensory, motor, and reflex function during spinal shock obscures the usual signs of significant blunt abdominal trauma. In a retrospective study of ten acutely quadriplegic patients, initial physical findings, vital signs, and hematocrit determinations were not found to be helpful in detecting intra-abdominal injury. Diagnostic peritoneal lavage was an accurate indicator of the presence or absence of significant intraperitoneal hemorrhage in all ten cases in this series.

Abdominal Injuries↗