Abdominal Trauma in Combat (original) (raw)
Related papers
Military Medicine, 2001
Objective: To analyze predictive factors for developing complications or lethal outcome in war abdominal trauma. Design: Retrospective study. Methods: We analyzed 93 cases of war penetrating abdominal trauma treated at the General Hospital Karlovac, Croatia. The following potential predictor variables were analyzed: age, sex, type of wound, Penetrating Abdominal Trauma Index (PATI), Injury Severity Score (ISS), and number of injured abdominal organs (NIAO). Results: A total of 10.8% of wounded patients died and 25.8% developed complications. The overall average number of injured intra-abdominal organs was 2.0; in the group of patients with complications, the average was 3.0, and in the group of deceased patients, the average was 3.5. The most frequently injured organs were the small and large bowels. The significant predictors of developing complications as well as death outcome were the PATI, the ISS, and the NIAO. The best diagnostic efficiency (79.57%) for predicting complications was with the NIAO, whereas the best model for the prediction of death outcome combined all three variables (Z =-13.0776 + 0.1561 x PATI + 0.281 x ISS-0.5234 X NIAO), with diagnostic efficiency of 92.47%. Conclusion: These models may be used as important prognostic factors in war abdominal injuries. time factor is of essential importance for the outcome of treatment.1 The frequency of abdominal injuries in war conditions has increased with the development of militarytechnology: 20/0 in World War1,4% in World WarII, and 70/0 in the Korean War. 2 In the VietnamWar, the percentage of abdominal injuries was 13.840/0 among 17,726 wounded," and in Kampuchea it was 13.60/0 among 1,033 wounded.' More recent studies, based on smaller series of wounded in Afghanistan" and the Persian Gulf." found abdominal injury frequencies of 12°A> and 11%, respectively. Rignaulf thinks the frequency of abdominallnjuries is closeto 200/0 on the battlefield, but half ofthe woundeddie from loss of blood immediately upon wounding. During the war in Croatia (1991 to 1995), injured civilians and Croatian soldierswere treated at the GeneralHospital Karlovac, among other hospitals. The front line passed through a suburb of the town of Karlovac, only 2 km from the hospital. Eleven surgeons and six anesthesiologists workedat the hospi
Nursing, 2007
Hidden in the abdomen, life-threatening injuries can elude detection. Find out how to evaluate your patient's condition and prevent further harm. By Cynthia Blank-Reid, RN, CEN, MSN Often involving multiple injuries, abdominal trauma can lead to hemorrhage, hypovolemic shock, and death. Yet even a serious, life-threatening abdominal injury may not cause obvious signs and symptoms, especially in cases of blunt trauma. To detect ominous changes in a patient's condition, you need to perform frequent, ongoing assessments and interpret your findings correctly. Key responses to decrease mortality and morbidity include aggressive resuscitation efforts, adequate volume replacement, early diagnosis of injuries, and surgical intervention if warranted.
Complications and Avoidance of the Complications Associated with Management of Abdominal Trauma
0
Despite decades of dramatic advance in treatment and prevention of trauma, globally trauma continues to be a major public health problem. More than 5 million individuals perish every year as a consequence of injuries. This is responsible for about 9% of the world's deaths, approximately 1.7 times the number of mortalities that result from HIV/AIDS, tuberculosis and malaria combined. Abdominal trauma continues to be the leading cause of mortality and morbidity in all age groups. A comprehensive management of traumatic abdominal patient with various approaches is of proven value in terms of mitigating the burden associated with abdominal trauma. However, all available approaches used to manage traumatic abdominal patient are potentially associated with development of various complications. Practical to mitigate these complications, various measures should be considered all the time while managing any traumatic abdominal patient. The goal of this chapter is to describe systematic approaches for avoiding the complications associated with management of abdominal trauma. Moreover, it describes the common and some rare complications associated with the management of traumatic abdominal patient.
The Trauma Golden Hour, 2019
Abdominal trauma is common when evaluating a patient in a trauma setting, either in isolation or combined with other injuries. According to the National Trauma Data Bank, the incidence surpasses 90,000 cases in 2013, with a 12.8% mortality rate. Abdominal trauma is classified according to mechanism, either blunt or penetrating, and each demonstrates different patterns of injury that dictate pathways for evaluation and management. In this chapter, we focus on the evaluation and management of penetrating abdominal trauma.
Perspectives on the Management of Abdominal Trauma
Austin Journal Of Surgery
The main consequences of abdominal trauma are haemorrhage and sepsis. Early deaths following abdominal trauma are usually attributable to haemorrhage. Sepsis is the most common cause in deaths occurring more than 48 hours after injury. Thus the first priority for the surgeon performing a laparotomy for abdominal trauma is haemorrhage control and prevention of spilling of visceral contents from visceral injuries is the second priority. In selected patients definitive repair is delayed until after a period of intensive resuscitation following damage-control surgery. The diagnosis or exclusion of hollow viscus injuries can be problematic. Excluding the general principles of trauma laparotomy and definitive intraabdominal procedures, the article discussed the clinical assessment and decisionmaking which would ensure that injuries are not missed during laparotomy and thus decrease mortality.
ScholarsReport, 2018
sUMMAry Introduction: It has long been thought that patients with open abdominal trauma should undergo surgery as soon as their clinical conditions permit, and that closed abdominal traumas put the surgeons in a dilemma whether or not they should operate and when they doubted the results could be catastrophic. Material and Method: An observational, retrospective and cross-sectional study of all patients with closed abdominal trauma in a general community hospital of the second level was conducted over a period of four years. Inclusion criteria: all closed abdominal traumas of any age, of both sexes and by any etiology. Exclusion criteria: open abdominal trauma, multiple trauma patients, cranioencephalic trauma and orthopedic trauma without abdominal involvement. Descriptive statistics were used for the results obtained. Results: During the study period, 38 cases of abdominal trauma were collected, of which nine were closed. Eight male and one female cases. At admission, two patients were reported in shock and seven were stable. Five cases were exclusively abdominal and four cases were thoraco-abdominal. Discussion: Closed abdominal trauma presents a diagnostic challenge and for the surgical evaluation of patients with closed abdominal trauma, a reliable physical examination is not possible when patients have concomitant injuries that cause disturbing pain, or when patients are unconscious. Exploratory laparotomy is necessary for up to 10% of patients with closed abdominal trauma and is only necessary when there is solid organ injury and the patient is hemodynamically unstable, with its exceptions.
Penetrating abdominal trauma. pdf
Scholars Report, 2018
sUMMAry Introduction: Patients with open or penetrating abdominal trauma are usually subjected to exploratory laparotomy, however, in selected cases, many surgeons decide not to operate and keep their patients under observation since this expectant attitude has avoided unnecessary laparotomies throughout the world. Material and Method: An observational, retrospective and cross-sectional study of open abdominal trauma was conducted over a period of four years. Inclusion criteria: all open abdominal traumas of any age, of both sexes and by any etiology. Exclusion criteria: closed abdominal trauma, multiple trauma patients, cranioencephalic trauma and orthopedic trauma without abdominal involvement. Results: During the study period, 38 cases of abdominal trauma were collected, of which 26 were open. Seventeen male and nine female cases. At admission, two patients were reported in shock and 24 were stable. Twenty-two cases were exclusively abdominal and four cases were thoraco-abdominal. Twenty-two cases were by the knife; two cases per firearm; two cases per rods. Three patients required a transfer to the ICU (splenectomy, iliac artery injury, and packaging). There were no deaths. Discussion: The decision to intervene surgically depends on whether the patient is stable or unstable, in the first case there is time to do the necessary studies, in the second the patient should be laparotomized to control the bleeding that causes the patient's state of shock. In our hospital, we have a shock unit and this helps greatly for the primary care of the injured and its evaluation by surgery.