PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “ABDOMINAL INJURIES”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,297 records · Page 72Linked to original sources
PubMed2003

Serum amylase and lipase alone are not cost-effective screening methods for pediatric pancreatic trauma.

BACKGROUND: Injury to the pancreas is rare in pediatric trauma. Identification of pancreatic injury relies on clinical, radiographic, and laboratory data. Serum screening for pancreatic injury frequently is used but has not proven to correlate well with pancreatic injury. This study investigated utility and cost effectiveness of serum assessment of amylase and lipase. METHODS: A retrospective study of 1,821 pediatric trauma patients over 64 months was conducted. A total of 293 (16%) of these patients suffered trauma to the torso 195 (11%) of whom had confirmed intraabdominal injury. Eight pancreatic injuries (4% of abdominal injuries) were identified; 5 underwent surgery for pancreatic ductal injury. One patient not operated on had a pseudocyst that required late drainage. RESULTS: Serum amylase or lipase levels (AMY/LIP) were measured in 507 (28%) patients. A total of 116 (23%) had elevated AMY/LIP levels. Six of 8 with proven pancreatic injury underwent AMY/LIP testing; 5 had elevated values. Forty-eight percent of patients with elevated AMY/LIP levels had no evidence of intraabdominal injury. Seventy-four of 116 (64%) with elevated AMY/LIP levels underwent abdominal and pelvic computed tomography (CT) scanning, yet 38 (51%) of these had completely normal scans. Many patients with elevated AMY/LIP levels (cost, $6 per test) underwent screening CT scans (cost, $592 per test) based on AMY/LIP alone. No patient with elevated AMY/LIP levels but without clinical suspicion was proven to have pancreatic injury. Cost data are presented. CONCLUSIONS: Serum amylase and lipase determinations may support clinical suspicion in the diagnosis of pediatric pancreatic trauma but are not reliable or cost effective as screening tools. Costs incurred from routine serum amylase and lipase or from imaging tests subsequent to elevated serum values may be significant and unjustified.

Abdominal Injuries↗
PubMed1999

Small-bowel and mesentery injuries in blunt trauma.

BACKGROUND: The purpose of this study was to identify factors that would aid in the diagnosis of small-bowel and mesentery injuries (SBMI) in blunt trauma patients. METHODS: Retrospective review of 15,779 blunt trauma patients admitted to a Level I trauma center between January 1991 and December 1996. RESULTS: A total of 5,303 patients sustained abdominal injuries, 70 of whom had more than 111 SBMI. Seventy-nine percent were victims of motor vehicle collisions. Thirty patients had isolated SBMI and 40 had associated intra-abdominal injuries. Twelve patients arrived with systolic blood pressure < 90 mm Hg, eight of whom died. Mean base deficit was -7.3 +/- 6.3 in 52 patients who had arterial blood gases determined. Fifty-three of 60 patients had hematuria. Sixty-seven patients required laparotomy. Delayed exploration occurred in 15 patients who underwent initial computed tomography but had subsequent changes in physical status. Two of 20 patients had negative diagnostic peritoneal lavage on admission and were eventually explored based on abdominal computed tomographic findings and changes in physical examination. There were 15 deaths. Delay in diagnosis (>12 hours after arrival) occurred in nine patients with no deaths or significant morbidities. Mean Injury Severity Score was 29 +/- 16.7: 43 +/- 17 in nonsurvivors and 25 +/- 14.3 in survivors (p < 0.05). CONCLUSION: The diagnosis of SBMI is often made in the presence of associated intra-abdominal injuries. Isolated SBMI are common, however, and special attention to the mechanism of injury, abdominal examination, presence of hematuria, and significant base deficit should raise suspicion to the possibility of SBMI. Findings on abdominal computed tomography that may suggest SBMI and should prompt further evaluation include free fluid, thickened bowel, and extraluminal air. Because delay in diagnosis does not seem to affect morbidity or mortality, dedication to observation and serial physical examinations will aid in the proper identification of elusive SBMI. Mortality, however, does appear to be related to the presence of hypotension on admission and associated injuries.

Abdominal Injuries↗
PubMed2003

Blunt abdominal trauma in sports.

Abdominal injuries are rare in sports, but when they do occur it is important that the physician recognize the warning signs of potentially life-threatening injury to the liver, spleen, or hollow abdominal viscera. Though the sports medicine physician may not always provide definitive treatment of many of these conditions, he or she should be familiar with the preferred diagnostic modalities and latest treatment options. This information is not only essential to appropriately participate in treatment decisions, but is also important in order to make return-to-play determinations.

Abdominal Injuries↗
PubMed2002

Therapeutic laparoscopy for abdominal trauma.

BACKGROUND: Instead of open laparotomy, laparoscopy can be used safely and effectively for the diagnosis and treatment of traumatic abdominal injuries. METHODS: Between February 1998 and January 2002, 78 hemodynamically stable patients (49 males and 29 females) with suspicious abdominal injuries underwent diagnostic or therapeutic laparoscopy. The patients ranged in age from 15 to 79 years (median, 40.9 years). Of these patients, 52 were evaluated for blunt trauma and 26 had sustained a stab wound. Preoperative evaluation with enhanced abdominal computed tomography (CT) showed some significant injuries in all cases. All of the laparoscopic procedures were performed in the operating room with the patient under general anesthesia. Pneumoperitoneum was established using an open Hasson technique at the umbilicus, and a forward-viewing laparoscope (30 degrees) was inserted. Two additional 5- or 10- and 12-mm trocars were placed in the right and left lateral quadrants for manipulation, retraction, aspiration-irrigation, coagulation, and the like. The abdominal cavity was systemically examined, the hemoperitoneum aspirated, and the lesion causing the bleeding or spillage located. RESULTS: On the basis of the laparoscopic findings, diagnostic laparoscopy was enough for 13 patients, and therapeutic laparoscopy was performed in 65 patients (83%) for gastric wall repair [8], small bowel repair [15], small bowel resection-anastomosis [19], ligation of bleeders in the mesentery and omentum [8], sigmoid colon repair [4], Hartmann's procedure [5] cholecystectomy [2], distal pancreatectomy [2], and splenectomy [2]. Totally laparoscopic procedures were performed in 43 patients, laparoscopically assisted procedures in 20 patients, and hand-assisted laparoscopic surgery in 2 patients. No significant abdominal injuries were missed as a result of laparoscopy, and no conversion to exploratory laparotomy was noted. The mean operation time was 142 min, and the mean hospital stay was 9.8 days. There were three cases of postoperative complications (1 wound infection, 1 paralytic ileus, and 1 atelectasis), but no missed injuries and no mortality. CONCLUSIONS: The short-term results from this study suggest that laparoscopy is a safe, feasible, effective procedure for the evaluation and treatment of hemodynamically stable patients with abdominal trauma, and that it can reduce the number of nontherapeutic laparotomies performed.

Abdominal Injuries↗
PubMed1992

Transvaginal intra-abdominal impalement injury.

Impalement injuries due to sexual activity are highly unusual and variable. We have described a case of transvaginal impalement injury of the rectum, bladder, omentum, and mesentery manifested by vaginal bleeding. The patient could not recount how she had been injured. Management of such an injury requires extensive initial evaluation and a multidisciplinary approach to therapy.

Abdominal Injuries↗
PubMed2005

[Medical care rendered to the wounded with abdominal nonpenetrating injury during pre-hospital stage].

Of 4477 lethal outcomes the death caused by ACI constituted 6.2%. At pre-hospital, stage the lethality was 45.7%, including 67%--from massive hemorrhage, 19%--from shock, 14%--from reflex cardiac arrest caused by abdominal stroke. Of 157 ACI cases 70% were admitted at the peak of development of posttraumatic complications, 20%--in 24 hours after trauma. According to "VPH-SP" scale the severity of casualties' state was the following: 18% (up to 12 points), 43% (16-17 points), 31.2% (21-23 points), 12% (34-37 points), 5% (45-53 points). At admission 36% had a shock, 50.3%--continuous hemorrhage, 18%--peritonitis symptoms. According to the investigation results the main factors that have an influence on the outcome during ACI are the qualitative skilled medical care at the place of trauma with the use of analgetics and infusion therapy as well as qualitative surgical care. Type of transport and speed of the wounded delivery are of minor importance. According to the state severity during ACI 3 groups were selected: up to 10 points; 10-20 points; 21-45 points. For each group the necessary optimal volume of medical care at prehospital stage was recommended (the use of analgetics, infusion and hemostatic agents). To improve the quality of medical care rendered to ACI casualties the medical service adequate to the trauma is required. Besides the emergency care units should be provided with sanitary transport equipped with special apparatus and have the trained medical staff.

Abdominal Injuries↗
PubMed1993

Blows to the maternal abdomen causing fetal demise: report of three cases and a review of the literature.

Traumatic abruption results in 6% of third-trimester gravidas who are hit or kicked in the abdomen during assaults. Three cases are presented in which blows inflicted to the abdomen of pregnant women in their third trimester resulted in the death of the fetus due to abruptio placentae. Two cases were domestic altercations while one was a third-party criminal assault. In all cases the gravida herself escaped significant intra-abdominal injury, and external abdominal findings were minimal. The clinical signs were a history of loss of fetal movements shortly after the assault and loss of fetal heart tones within hours after the assault. One patient had vaginal bleeding; one had uterine contractions. In the cases of domestic abuse, both women initially gave false histories of how the injury occurred.

Abdominal Injuries↗
PubMed2001

[Evaluation of patients wounded in the 17 August 1999 Marmara earthquake].

This study describes the experience of Kartal Research and Training Hospital in the Marmara Earthquake. We reviewed medical records of 698 patients admitted to our hospital in a 30 days' period after the earthquake and analysed the types of injuries, treatment, morbidity and mortality rates. The hospitalized 273 patients were grouped according to the major injury; patients with crush syndrome were analysed separately. The most frequent injuries were crush injury (23.1%), extremity fractures (16.8%) and pelvis and spine injuries (16.1%). More than two system injuries were seen most frequently in the abdominal injury (45.5%), crush injury (24.4%), and pelvis and spine injury (27.3%) groups (p < 0.05). Overall mortality rate was 7.3%. The highest mortality rates were seen in the abdominal injury (27.3%) and crush injury (20%) groups (p < 0.05). 61.9% of the patients with crush syndrome underwent fasciotomy due to the compartment syndrome; hemodialysis was performed in 31 patients. The most serious problem with earthquake is organization in the earthquake area, between hospitals and in hospitals. Crush injury is the major injury seen earthquakes. Early diagnosis and proper treatment should be done to improve survival.

Adult↗
PubMedDate not supplied

An unusual stingray injury--the skindiver at risk.

Serious abdominal injury following a stingray attack on a skindiver is described. Knowledge of the creature's habits and the avoidance of swimming along the seabed are recommended as precautionary measures against such an injury.

Abdominal Injuries↗
PubMed1999

[Transport management in blunt abdominal trauma. Case report of a patient with delayed diagnosis of splenic rupture].

Missed abdominal injuries after blunt abdominal trauma belong to the most frequent causes of death, especially in polytraumatized patients. Primary missing these injuries often is a tragedy due to a mortality-rate up to 50% after delayed treatment compared with a low complication- and mortality-rate after diagnosis in time. We report the case of a patient with a missed spleen lesion to discuss the special problems of the transport stages. Transport and diagnostic procedures are critical stages because of limited diagnostical and therapeutical possibilities. There is a risk of inadequate therapy in case of a sudden debasement of the patient's condition. Therefore sufficient monitoring and the availability of emergency medicals and tools are essential to secure an adequate treatment of secondary decompensation. These conditions are indispensable for the primary transport, innerhospital transfers and also for secondary interhospital transfers. Supervision during the transport stages by a doctor who is able to carry out life-saving emergency treatments is essential. Sudden debasement of the patient's condition often requires short-dated decision making concerning the following diagnostical and therapeutical strategy.

Abdominal Injuries↗
PubMed1986

[Negative laparotomies in gunshot and stab injuries of the abdomen].

A selective approach is taken, as a matter of principle, to cases of abdominal injuries at the Traumatological Department of the Faculty of Medicine at Instanbul University. Surgical treatment was applied to 378 in 2,968 hospitalised patients for contused or penetrating abdominal injuries, in 1983 and 1984. The rate of negative laparotomy was as low as 7.3 per cent owing to routine peritoneal flushing. However, laparotomy has been preferred and resulted in a negative laparotomy rate of 21 per cent, since problems are quite often faced in the diagnosis of stab injuries.

Abdomen, Acute↗
PubMed2006

[The relationship of the expression of principal pattern recognition receptor with the pulmonary injury in abdominal infection-induced sepsis].

OBJECTIVE: In order to investigate the evidence of the synergistic effects of bacterial components, to observe the relationship of the expression of lipopolysaccharide (LPS) receptors [CD14, Toll-like receptor 4 (TLR4), scavenger receptor (SR)], lipoprotein receptor (TLR2) and bacterial DNA receptor (TLR9) with pulmonary injury in abdominal infection-induced sepsis. METHODS: 30 mice were used and randomly divided into cecal ligation puncture (CLP) (n = 15) and sham (n = 15) groups. The animals were respectively sacrificed 8, 12 and 24 (each point n = 5) hours following CLP and sham CLP. The lungs were removed and immediately stored in liquid nitrogen for TLRs mRNA, tumor necrosis factor (TNF) alpha and myeloperoxidase (MPO) assay. To detect the expression of CD14, TLR4, SR, TLR2 and TLR9 mRNA by reverse-transcription polymerase chain reaction, to detect the TNF-alpha content of the lung tissue by enzyme-labeled immunosorbent assay, and to assay the MPO activity of the lung tissue spectrophotometer. RESULTS: It was found that the expression of receptors for LPS, BLP and bacterial DNA in pulmonary tissues was markedly changed in CLP-induced sepsis, showing upregulation of CD14 mRNA (1.143 +/- 0.139, t = 0.022, P < 0.05), TLR2 mRNA (0.418 +/- 0.102, t = 0.021, P < 0.05), TLR4 mRNA (0.595 +/- 0.052, t = 0.0001, P < 0.01) and TLR9 mRNA (0.743 +/- 0.178, t = 0.0023, P < 0.01) at different degrees (P < 0.05 or P < 0.01) after postinjury 8 h, among which the expression of TLR9 mRNA kept increasing. The expression of SR mRNA (8 h: 0.659 +/- 0.159; 12 h: 0.429 +/- 0.061; 24 h: 0.300 +/- 0.045; t = 0.029, P < 0.05; t = 0.001, P < 0.01; t = 0.003, P < 0.01) showed continuous down-regulation. CONCLUSION: There was a marked correlation between the changes of pattern-recognition receptor expression and the increases of MPO and TNF-alpha levels in pulmonary tissues.

Animals↗
PubMed2004

[Complete avulsion of ureter caused by abdominal blunt injury: a case report].

A 21-year-old woman who had been injured in a traffic accident appeared with abdominal pain and macroscopic hematuria. Computed tomography (CT) performed 6 hours after the injury showed extravasation of contrast medium in the right retroperitoneal space. Retrograde pyelography (RP) showed the interruption of right ureter at the site of ureteropelvic junction. We performed an abdominal operation 15 hours after the injury under the diagnosis of right ureteral avulsion. We observed a completely separated right ureter at the ureteropelvic junction, and performed an end to end anastomosis. The patient was discharged three weeks after surgery, and has not had any problems for three years.

Abdominal Injuries↗