By Harry M. Delany M.D., F.A.C.S., Robert S. Jason M.D. (auth.)
Trauma to the stomach, either unintended and willful, has turn into more and more universal during this period of accelerating violence. huge numbers of sufferers everywhere in the kingdom are admitted to emergency rooms as a result of belly trauma of various levels of severity. All too usually the proper analysis is suspected belatedly or certainly not, in order that right therapy isn't really initiated in enough time to be lifesaving. now not infre quently, the injured sufferer is tested via an intern or an insufficiently skilled resident general practitioner. Even in circumstances the place extra senior internists and surgeons can be found, designated wisdom in regards to the invaluable technique to set up the proper analysis and institute the right remedy is missing. This monograph, representing the felicitous collaboration of a healthcare professional and a radiolo gist including a number of different members, is well timed and significant. The authors (and their individuals) have approached their topic with a wealth of medical experi ence received in numerous very energetic acute-care municipal hospitals within the greatest urban during this nation. they've got saw and handled a really huge variety of sufferers with a mess of disturbing explanations, together with firearm accidents, stab wounds, vehicular injuries, falls, and attacks. The authors have divided this paintings into 4 major sections: common views on belly damage, kinds of stomach accidents, particular Diagnostic options, and particular Organ or Supporting-Structure Injury.
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Extra info for Abdominal Trauma: Surgical and Radiologic Diagnosis
Source: Bolton PW, Wood CB, Quartey-Papafio JB, Blumgart LH (1973) Blunt abdominal injury: A review of 59 consecutive cases undergoing surgery. 39. Area of injury and apparent errors in management Organs injured Spleen Kidney Liver Liver + other solid viscera Spleen + pancreas Bladder Intestine Solid + hollow viscera Major vessel Major vessel + viscera Total Delay in diagnosis and surgery Inadequate resuscitation 2 Inadequate resuscitation plus delay Operative error 2 I" 5 7 Total 7 I 3" I" I 7 No major error I" 2 3 5 2 3 I 2 12 2 4 6 2 4 33 One person in each of these categories would have had a poor chance of survival even with optimum care.
27. Reliability of abdominakavity penetration as a predictor of injul)I Missile course No. 6 o Source: Lowe RJ, Salletta JD, Read DR, Radhakrishnan J, Moss GS (1977) Should laparotomy be mandatory or selective in gunshot wounds of the abdomen. 28. Abdominal gunshot wounds: Major indications for surgery Indication Peritoneal signs Absent bowel sounds Shock Positive IVP or cystogram Blood in the G I tract Pneumoperitoneum Evisceration None Injury found No injury found 197 80 59 35 23 15 30 4 0 3 0 0 0 24 3 17 Source: Lowe RJ, Salletta JD, Read DR, Radhakrishnan J, Moss GS (1977) Should laparotomy be mandatory or selective in gunshot wounds of the abdomen.
In: Margulis AR, Burhenne HJ (eds) Alimentary Tract Roentgenology, Vol. I. V. Mosby Co, St. Louis, pp 228-270 28. Moss LK, Schmidt FE, Creech 0 Jr (1962) Analysis of 550 stab wounds of the abdomen. Am Surg 28: 483 29. Nance CF, Cohn I Jr (1969) Surgical judgment in the management of stabwounds of the abdomen: A retrospective and prospective analysis based on a study of 600 stabbed patients. Ann Surg 170(4): 569-580 30. Netterville RE, Hardy JD (1967) Analysis of 155 cases with problems in management.