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At least 973 records · Page 54Linked to original sources
PubMed1993

[The role of an abdominal injury in follow-up of polytrauma patients].

Patients with multiple injuries were studied retrospectively (n = 483, ISS = 28 pts) and prospectively (n = 133, ISS = 42 pts) to determine the significance of concomitant intraabdominal lesions in the management and outcome of these subjects. In the retrospective part of the investigation 134 patients with intra-abdominal trauma presented with significantly more severe injuries (ISS = 38) as compared to 349 subjects with bland abdomen (ISS = 25). This resulted in a significantly different mortality rate (27 vs 11%). 119 patients with abdominal trauma were managed operatively, with surgery instituted within 4 hrs after the accident in 104 cases. Delayed abdominal surgery was performed in 18 patients due to complications from the initial laparotomy and in 15 cases because of delayed diagnosis. Delayed operations resulted in an increased rate of local complications (33 vs. 6%). In the prospective part of the study 33 out of 133 patients succumbed during resuscitation. In 14 of these, intractable bleeding from abdominal lesions was identified as the cause. In the 100 primary survivors, there was found no difference between 41 patients with and 59 patients without abdominal pathology with respect to injury severity, mortality, complications, initial hemodynamic parameters or the secondary release of inflammatory mediators. However, the initial requirement for red blood cell substitution was significantly higher in subjects with intra-abdominal trauma. Our results demonstrate that massive intra-abdominal hemorrhage may cause early mortality. In primary survivors, abdominal lesions have not shown to be of prognostic relevance, provided that early resuscitation, early diagnosis and early operative therapy can be instituted.

Abdominal Injuries↗
PubMed1976

Limb and abdominal injuries: principles of treatment.

In the period reviewed, the Royal Victoria Hospital received over 7000 casualties, representing approximately half of the civil disturbance injuries for the province. Primary resuscitation did not differ from that of road traffic accidents, but the surgical management did. Extensive débridement was essential, followed by delayed primary suture some days later. Two hundred and nine penetrating abdominal wounds were reviewed, and the necessity of exploring the abdomen in all such injuries is emphasized.

Abdominal Injuries↗
PubMed2006

Comparison between computed tomography (CT) and autopsy findings in cases of abdominal injury and disease.

We report 10 autopsy cases involving fatal pathological changes in abdominal organs, for which findings of computed tomography (CT) on admission or after death were compared with autopsy findings. Two of the cases were death due to natural causes and eight were death due to traffic accidents. From the findings at autopsy, the causes of death were considered to be rupture of an aortic aneurysm in one case, gastrointestinal bleeding due to gastric cancer in one case, retroperitoneal bleeding in two cases, laceration of the liver in three cases, and traumatic rupture of the small intestine in three cases. CT findings revealed ascites or retroperitoneal bleeding in eight cases. However, in the cases of small-intestinal rupture, CT findings on admission revealed no free air. Therefore, ascites on CT should be regarded as a useful indicator of blunt abdominal trauma. Hepatic portal venous gas, known to be a post-mortem change, was significantly evident on post-mortem CT in cases of traumatic liver or intestinal injury, and was also seen in cases where the period between the accident and CT examination was long.

Accidents, Traffic↗
PubMed1998

[Laparoscopy in abdominal injuries].

Application of laparoscopy in trauma was studied in Traumatological Hospital in Brno, within a more widely concipated project of grant IGA, Ministry of Health in Czech Republic. In the series of 28 patients there was detected neither a single complication, nor a reoperation nor any significant damage to the patient in connection with the use of the endoscopic method detected. Results of the research and author's observations act as a guide for use of more precise indication criteria and adequate selection of patients and for the proper evaluation of the method. Provided that basic principles and priorities of the urgencies management are kept, the application of this minimally invasive method in the management of patients with selected both the blunt and the penetrating abdominal trauma is justified, including associated extraabdominal injuries and polytrauma. It's diagnostic contribution exceeds the therapeutic one.

Abdominal Injuries↗
PubMed2001

[Ultrasonographic scanning of patients with severe abdominal injuries].

INTRODUCTION: The aim of this study was to describe our experiences with ultrasonography (US) of severely traumatised patients, and to show whether it is a safe and fast procedure when screening for intra-abdominal lesions. MATERIAL AND METHODS: In a period from 1996 to 1999, 876 patients were received by the trauma team. The number of patients with an injury severity score (ISS) > 15, was constant during the period. Seventy-five per cent of the patients were men. One hundred and fifty-five patients (18%) died, 111 before US was carried out. RESULTS: Over the four-year period, the number of patients received by the trauma team increased from 150 in 1996 to 365 in 1999. The number of US examinations increased from 61 (1996) till 303 (1999). The number of pathological US scans was constantly about 20 per year, where as the number of pathological CT scans was between ten and 20 per year. The number of patients that went on to explorative laparotomy was between seven and 17 per year and 49 in the whole period. The sensitivity of US to detect abdominal lesions is 0.74 and the specificity 0.97, whereas that to detect free abdominal fluid is 0.88 and the specificity 0.99. DISCUSSION: US of the abdomen is a fast and safe procedure to carry out on the severely traumatised patient. An algorithm for diagnosis is suggested.

Abdominal Injuries↗
PubMed1989

[Peace-time thoraco-abdominal injuries].

The article discusses the diagnosis of thoracoabdominal wound (TAW) in 190 patients and the results of their operative treatment, information given in a questionnaire by 70 patients and out-patient examination of 19 of them in the late-term period. The clinical abdominal symptomatology is encountered 7 times more frequently in TAW than in and in combination with the X-ray signs allowing the diagnosis to be made in 21.58% of cases with TAW. Contrast study of the wound canal, thoracoscopy, and diagnostic pneumoperitoneum make it possible to establish or reject the diagnosis of TAW in all patients examined. Thoracotomy in the 7th intercostal space or at a lower level with transdiaphragmatic laparotomy allows for correction of the injuries in the chest and abdomen in 92.30% of patients. The mortality rate was 2.63%.

Abdominal Injuries↗
PubMed1978

[Blunt abdominal injuries in childhood (author's transl)].

Traffic accidents are among the most important causes of child death. It is sometimes quite difficult to diagnose blunt abdominal traumata due to traffic accidents. 35 blunt hepatic and splenic injuries treated in our clinic during the period of 1971 to 1976 have been evaluated and pertinent references reviewed.

Accidents, Traffic↗
PubMed1985

Analytical diagnostic peritoneal lavage in the diagnosis of intra-abdominal injury.

Diagnostic peritoneal lavage (DPL) was modified to detect dynamic changes occurring in lavage fluid in dogs following liver, spleen, or intestinal injury. In 33 animals lavage fluid was serially sampled over 75 minutes and analyzed for RBC and other variables. The spun sediment was Gram stained. In control groups, either saline or autologous blood was instilled into the peritoneal cavity at a known rate. In these experiments, the composition of lavage fluid did not significantly change over time. Blood infused at a constant rate into the abdominal cavity produced corresponding, continuing increases in the RBC count. In experimental groups, the liver, spleen, or intestine were injured before lavage. Only initial RBC counts greater than 1 million/mm3 or rising RBC counts in serial lavage samples were associated with life-threatening hemorrhage. Gram stains of samples were positive for bacteria in 43% of fasted dogs and in 80% of fed dogs with intestinal perforation.

Albumins↗