By Harry M. Delany M.D., F.A.C.S., Robert S. Jason M.D. (auth.)
Trauma to the stomach, either unintentional and willful, has develop into more and more universal during this period of accelerating violence. huge numbers of sufferers everywhere in the nation are admitted to emergency rooms due to 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 initiated in adequate time to be lifesaving. now not infre quently, the injured sufferer is tested by way of an intern or an insufficiently skilled resident medical professional. Even in cases the place extra senior internists and surgeons can be found, precise wisdom concerning the useful technique to set up the proper prognosis and institute the ideal therapy is missing. This monograph, representing the felicitous collaboration of a health care professional and a radiolo gist including a number of different members, is well timed and significant. The authors (and their members) have approached their topic with a wealth of medical experi ence bought in different very lively acute-care municipal hospitals within the biggest urban during this nation. they've got saw and handled a truly huge variety of sufferers with a large number of annoying factors, together with firearm accidents, stab wounds, vehicular injuries, falls, and attacks. The authors have divided this paintings into 4 major sections: common views on stomach damage, forms of stomach accidents, particular Diagnostic concepts, and particular Organ or Supporting-Structure Injury.
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Extra resources for Abdominal Trauma: Surgical and Radiologic Diagnosis
8 days Source: Lowe RJ, Salletta JD, Read DR, Radhakrishnan J, Moss GS (1977) Should laparotomy be mandatory or selective in gunshot wounds of the abdomen. J Trauma 17: 903-907 cations, a selective approach to abdominal injuries often results in a shortened hospital stay and financial savings. The Military Experience The most recent military experience with injuries to the abdomen has been almost exclusively with penetrating wounds. 2% of wounds in Vietnam. This was the same pattern observed in World War II and the Korean War.
Source: Gertner HR, Baker SP, Rutherford RB, Spitz WV (1972) Evaluation of the management of vehicular fatalities secondary to abdominal injury. 's study is important because it emphasizes the subtle nature of isolated blunt abdominal injury and clearly demonstrates that the failure to evaluate such patients aggressively has unfortunate and ominous consequences. A combination of diagnostic procedures can be quite useful in blunt-trauma patients if there is the slightest evidence ofintraabdominal injury or hemodynamic instability.
Urinary-tract bleeding 5. Free intraperitoneal air 6. Evisceration of bowel 7. Uncontrolled bleeding from the wound 1. If patient has evisceration, shock, or obvious peritonitis, do not delay appropriate treatment. 2. Exploratory laparotomy will be carried out on the following indications: a. Evisceration of an intraperitoneal structure such as omentum of bowel b. Signs of intraperitoneal injury-particularly diffuse guarding or tenderness, rebound, or decreased or absent bowel sounds c. Blood in the nasogastric tube or on rectal examination d.