[Blunt abdominal injury in childhood].
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Details are presented of 104 patients admitted over a 1-year period with evisceration following penetrating abdominal wounds. Stabbing was the most common cause of injury. Small bowel was the most commonly eviscerated organ, as well as the organ most frequently injured. Exploratory laparotomy was performed on all the patients who survived to reach the operating theatre. The negative laparotomy rate was 12 per cent, and a further 3 per cent had such mild visceral injuries that they did not require operative repair. For comparison a group of 111 patients admitted over the same period, but suffering only omental protrusion, was also examined. The rate of visceral injury in this group was slightly lower. Wound complications, including breakdown, were more commonly seen in the eviscerated patients, but the mortality was 8 per cent in both groups.
Personal experience is reported in the use of peritoneal lavage in closed abdominal trauma to provide rapid, definitive diagnosis of haemoperitoneum. The techniques to be employed in order to obtain accurate diagnosis without any of the complications reported in the literature are specified and the advantages of the technique in resolving diagnostic uncertainties are analysed.
The authors present a case of complete ureteral rupture, after closed, abdominal traumatism in a patient suffering from multiple traumatisms. They point out the slight number of cases published in the literature as well as the frequency of its delayed diagnosis due to few or no symptoms, particularly when associated with visceral ruptures or bone fractures which may conceal the picture. They recommend the I.V.U. for all patients with multiple traumatisms once they have recovered from the state of shock, as a simple exploration but which provides a great deal of information. They also advise conservative treatment even in cases with a delayed diagnosis.
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