AI Article Synopsis
- CT scanning is crucial for managing civilian penetrating abdominal trauma, leading to fewer unnecessary surgeries and complications.
- In a study of 133 patients with severe abdominal injuries in Afghanistan, those who underwent CT had better outcomes, with no deaths compared to 15 in the surgery group.
- CT scans can safely identify patients who can be treated nonoperatively, especially in stable individuals with battlefield injuries.
Article Abstract
Background: Computed tomography (CT) scanning is a vital imaging technique in selecting patients for nonoperative management of civilian penetrating abdominal trauma. This has reduced the rate of nontherapeutic laparotomies and associated complications. Battlefield abdominal injuries conventionally mandate laparotomy, and with the advent of field deployable CT scanners it is unclear whether some ballistic injuries can be managed conservatively.
Methods: A retrospective 12 month cohort of patients admitted to a forward surgical facility in Afghanistan who sustained penetrating abdominal injury severe enough to warrant laparotomy or CT scan were studied. Patient details were retrieved from a prospectively maintained operative log and CT logs. Case notes were then reviewed and data pertaining to injury pattern, operative intervention, and survival were collected.
Results: A total of 133 patients were studied: 73 underwent immediate laparotomy (Lap group) and 60 underwent CT scanning (CT group). Of those undergoing CT scanning 17 underwent laparotomy and 43 were selected for nonoperative management. There were 15 deaths in the Lap group and none in the CT group. The median New Injury Severity and Revised Trauma Score was 29 and 7.55 in the Lap group and 9 and 7.8408 in the CT group, which is statistically significantly different (p < 0.001). Five patients in the CT-Lap group had nontherapeutic laparotomies and 1 patient failed nonoperative management.
Conclusions: Computed tomography scanning can be used in stable patients who have sustained penetrating battlefield abdominal injury to exclude peritoneal breach and identify solid abdominal organ injury that can be safely managed nonoperatively.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00268-010-0782-z | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Penetrating Chest Trauma With Right Atrial Rupture: A Case Report.
Cureus
December 2024
Student Research Unit, School of Medicine, 21 September University, Sana'a, YEM.
Penetrating thoracic injuries, especially those affecting cardiac structures, are rare but can be life-threatening, requiring urgent medical care. Right atrium injuries pose significant risks, including rapid blood loss, cardiac tamponade, hemodynamic instability, and, subsequently, potential death. We report the case of a 24-year-old male patient with stab wounds leading to a right-sided chest penetration three hours prior to presentation.
View Article and Find Full Text PDFCommon Iliac Vein Injury Due to a Rectal Impalement Wound Treated Conservatively.
Am J Case Rep
December 2024
Department of Emergency and Critical Care Medicine, Nippon Medical School Musashi Kosugi Hospital, Kawasaki, Kanagawa, Japan.
BACKGROUND Iliac vein injuries usually require surgical intervention due to their high mortality rates. Although conservative management may be applicable in some cases of blunt trauma, the suitability of this approach for treating penetrating injuries remains underexplored. CASE REPORT A 51-year-old man sustained a common iliac vein injury following rectal impalement in a collapsing chair.
View Article and Find Full Text PDFHigh Joule heat as a risk factor for post-endoscopic submucosal dissection electrocoagulation syndrome: A multicenter prospective study.
World J Gastrointest Endosc
December 2024
Department of Gastroenterology, Hitachi General Hospital, Ibaraki 317-0077, Japan.
Background: Thermal damage may lead to inflammation of the peeled mucosal surface during endoscopic submucosal dissection (ESD).
Aim: To determine the effect of Joule heat on the onset of post-ESD electrocoagulation syndrome (PECS).
Methods: In this prospective study, PECS was characterized by in-hospital fever (white blood cell count: ≥ 10000 μ/L or body temperature ≥ 37.
Pancreaticoduodenectomy in trauma patients with grade IV-V duodenal or pancreatic injuries: a post hoc analysis of an EAST multicenter trial.
Trauma Surg Acute Care Open
December 2024
University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Introduction: The utility of pancreaticoduodenectomy (PD) for high-grade traumatic injuries remains unclear and data surrounding its use are limited. We hypothesized that PD does not result in improved outcomes when compared with non-PD surgical management of grade IV-V pancreaticoduodenal injuries.
Methods: This is a retrospective, multicenter analysis from 35 level 1 trauma centers from January 2010 to December 2020.
Traumatic abdominal wall hernia (TAWH) is a rare but serious condition resulting from blunt abdominal trauma, characterized by the herniation of bowel or abdominal organs through a disrupted musculature and fascia without skin penetration. This report describes a unique case of a 24-year-old man who sustained a high-velocity blunt abdominal injury from a motorcycle handlebar during a road traffic accident. The clinical presentation, diagnostic challenges, surgical intervention, and postoperative recovery are discussed to emphasize the importance of the early recognition and management of TAWH in trauma patients.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!