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[Surgical treatment of closed abdominal injuries].

The experience with diagnosis and treatment of closed abdominal injuries in a specialized department of polytrauma for 3 years is summarized. The diagnostic and surgical tactics in given pathology consisting in early diagnosis of possible injuries to the viscera and emergency operative intervention is presented.

Abdominal Injuries↗

Patterns of abdominal injuries in frontal and side impacts.

Public awareness for safety and vehicle improvements has contributed to significant reduction in injuries secondary to motor vehicle crashes. The spectrum of trauma has shifted from one region of the body to another with varying consequences. For example, airbags have minimized head and neck injuries for adults while emphasizing the lower regions of the human body. Studies have concentrated on the changing patterns of these injuries in frontal impacts. However, there is almost a paucity of data with regard to the characterization of abdominal injuries. Consequently, this study was conducted to determine the patterns of abdominal injuries in frontal and side impacts with an emphasis on more recent crashes. In particular, the frequency and severity of trauma were investigated with a focus on the various abdominal organs (e.g., spleen and liver). Results indicate that side crashes contribute to a large percentage of injuries to the abdomen. The liver and spleen organs are most vulnerable; therefore, it may be beneficial to apply concerted efforts to focus on injury biomechanics research and prioritization activities in these areas of the abdomen. These data may be of benefit to develop anthropomorphic dummies with improved biofidelity.

Abdominal Injuries↗

Pattern of abdominal injuries in Aminu Kano Teaching Hospital, Kano.

This study was carried out to look at the pattern of abdominal trauma in Kano, and to compare our findings with those of other centres in Nigeria, and elsewhere. This was a retrospective analysis of all cases of abdominal trauma seen and operated upon from January 1997 to December 2001, in Aminu Kano Teaching Hospital, Kano. Sixty-seven patients were managed during the study period. They were all males, with a peak age range of 20 - 29 years. Penetrating abdominal injury occurred in 36 patients (53.7%), with 15 of them (44.4%) arising from missile injuries. Thirty-one patients (46.3%) sustained blunt abdominal trauma, mainly from road traffic accidents in 80.6% of cases. The spleen was the most commonly injured organ in blunt abdominal trauma occurring in 18 patients (58.1%), while in penetrating injury, it was the small bowel in 19 patients (55.5%). The mortality rate in this study was 8.9%. Abdominal injuries are quite common in Nigeria and remain a major source of morbidity and mortality. Preventive strategies should be focused on reduction of road traffic accidents, violent crimes and social conflicts.

Abdominal Injuries↗

[Relaparotomy in abdominal injuries in children].

An analysis of 18 relaparotomies in 12 children with injuries of the abdominal organs is presented. Inadequate measures against paresis immediately after laparotomy are felt to be the main cause of reoperations for an adhesive-dynamic form of the obstruction. While accomplishing relaparotomy, it is recommended not to resort to reconstructive operative procedures in cases where a palliative operation promptly liquidating complications would suffice.

Abdominal Injuries↗

[Diagnosis of peritonitis in abdominal injuries].

Peritonitis was found to develop in 250 (20,8%) out of 1200 patients with closed injuries of the abdominal organs and penetrating wounds of the abdominal cavity. The employment of different methods of prophylaxis and treatment of peritonitis at early terms permitted reducing its incidence 2-3 times.

Abdominal Injuries↗

Abdominal injuries in survivors of road trauma before and since seat belt legislation in Victoria.

At St Vincent's Hospital, Melbourne, the number of patients admitted annually with road crash injuries has remained almost constant for the past 14 years. Comparing admissions in the seven years before and during the seven years since enactment of seat belt legislation in Victoria, there has been no change in the proportion of those admitted with abdominal injuries, in the number of associated non-abdominal severe injuries, or in the death rate of those admitted with abdominal injuries. There has, however, been a significant increase in the number of patients admitted with injuries of the gastrointestinal tract and diaphragm. It is suggested that this increase is due to incorrect wearing of the lap component of seat belts with resulting acute abdominal compression.

Abdominal Injuries↗

[Isolated rupture of the intact gallbladder following blunt abdominal injury].

Isolated injury of the intact gallbladder following obtuse abdominal injury is rare. In connection with one case authors give a literary review of the occurrence of this injury. The pathogenesis of the rupture of the gallbladder, the clinical course and the difficulties of diagnosis are analysed.

Abdominal Injuries↗

Intra-abdominal injuries.

With the increase in mechanization, the incidence of intra-abdominal injury is increasing. Bleeding, contamination or impairment of function of an intra-abdominal organ must be diagnosed early and dealt with immediately. Serial determination of hemoglobin and cell volume of the blood are useful diagnostic procedures. The older teachings of waiting for a patient to recover from shock before operating are to be decried. Immediate operative intervention to close a ruptured stomach, bowel or bladder, or to suture or remove may be necessary to save the life of the patient.

Abdomen↗

Splenic trauma from blunt abdominal injury.

Thirty-nine cases of splenic trauma from blunt abdominal injury are presented. Road trauma was the most common aetiological factor, and young adults were predominantly affected. Internal haemorrhage was the main determinant of the clinical picture, and nine cases of delayed haemorrhage following splenic trauma are reported. Associated injuries were present in two-thirds of cases and contributed to the high morbidity and mortality rate of splenic trauma. The operative and non-operative management of splenic trauma is discussed, and the roles of isotope spleen scans are demonstrated.

Abdominal Injuries↗