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PubMed1980

[Gastric lesions in closed abdominal injuries (considerations on 8 cases)].

The Authors present 8 cases of traumatic lesions of the stomach, during the course of closed abdominal trauma, observed in the First Aid and Emergency Surgery Division of the Niguarda Ca' Granda Hospital, Milan, in the years 1970-1979. They take this as the starting point for a re-examination of the etiopathogenetic and anatomopathological data, and for diagnostic, prognostic and therapeutic considerations.

Abdominal Injuries↗
PubMed1991

Contributions of peritoneal lavage enzyme determinations to the management of isolated hollow visceral abdominal injuries.

STUDY OBJECTIVE: To determine the role of lavage amylase (LAM) and lavage alkaline phosphatase (LAP) in the identification of intraperitoneal hollow visceral injuries. DESIGN: Retrospective. SETTING: Level I trauma center, city/county institution. TYPE OF PARTICIPANTS: Patients with hollow visceral organ injury following major blunt or penetrating trauma whose diagnostic peritoneal lavage was negative by lavage red blood cell and lavage white blood cell were negative. MEASUREMENTS AND MAIN RESULTS: Fifty-one patients with injury isolated to one or more hollow visceral structures underwent diagnostic peritoneal lavage; 28 were positive based on aspirate, lavage red blood cell count (greater than 100,000/mm3), or lavage white blood cell count (greater than 500/mm3). Of the remaining 23 patients, each of 11 with isolated small bowel injury had LAM greater than or equal to 20 IU/L and six of these had LAP levels greater than or equal to 3 IU/L. All six patients with colon injury and two of the patients with gallbladder injury had LAM less than 20 IU/L and LAP less than 3 IU/L. CONCLUSIONS: In patients with hollow visceral injury and otherwise normal diagnostic peritoneal lavage, elevation in LAM is highly specific for isolated small bowel injury. Lavage enzyme determinations appear unhelpful in the detection of colonic injury. We recommend routine enzyme determinations of lavage effluent as a marker for isolated small bowel injury.

Abdominal Injuries↗