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 state are admitted to emergency rooms due to stomach trauma of various levels of severity. All too frequently the proper prognosis is suspected belatedly or certainly not, in order that right remedy isn't initiated in enough time to be lifesaving. now not infre quently, the injured sufferer is tested via an intern or an insufficiently skilled resident health professional. Even in situations the place extra senior internists and surgeons can be found, special wisdom concerning the useful technique to set up the proper prognosis and institute the correct therapy is missing. This monograph, representing the felicitous collaboration of a general practitioner and a radiolo gist including numerous different participants, is well timed and demanding. The authors (and their members) have approached their topic with a wealth of medical experi ence got in different very energetic acute-care municipal hospitals within the biggest urban during this state. they've got saw and handled a truly huge variety of sufferers with a large number of aggravating 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, different types of stomach accidents, particular Diagnostic recommendations, and particular Organ or Supporting-Structure Injury.
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Extra info for Abdominal Trauma: Surgical and Radiologic Diagnosis
Lowe et al. emphasized the value of assessment of the bullet wound to determine whether there has been penetration of the peritoneal cavity by the missile. 29). Thus, careful diagnostic study of the wound to determine the extent of abdominal-wall and peritoneal injury is important. Tangential abdominal-wall gunshot wounds can produce enough local effect to cause the typical tenderness, rigidity, and rebound of peritonitis. The morbidity rate in trauma for simple abdominal laparotomy, when no significant visceral injury is found, is reported as significant .
J Trauma 8(a): 1004-1010 Feltis JM (1970) Surgical experience in a combat zone. Am J Surg 119: 275 Fitzgerald JB, Crawford ES, DeBakey ME (1960) Surgical consideration of non-penetrating abdominal injuries: An analysis of 200 cases. Am J Surg 100: 22 Fitzgerald JB, Quast DC, Beahl AC, DeBakey ME (1965) Surgical experience with 103 truncal shotgun wounds. J Trauma 5: 72 Blunt, Nonpenetrating Injuries 12. Forde KA, Ganepola AP (1974) Is mandatory exploration for penetrating abdominal trauma extinct?
In experienced hands the examination has an accuracy rate of 90%. However, certain limitations do exist. First, the procedure is quite painful. Second, serial abdominal examinations may be precluded by the presence of residual contrast and/or air secondary to the infusion. Third, the examination only indicates entrance of the peritoneal cavity which does not necessarily indicate visceral injury or penetration. 7% as well as a significant false-negative rate. False negatives are attributed to (a) the use of peritoneal lavage prior to this examination, (b) the presence of multiple penetrating wounds, (c) insufficient volume of contrast and injection pressure, and (d) the unreliability of the technique when the pleura has been entered.
Abdominal Trauma: Surgical and Radiologic Diagnosis by Harry M. Delany M.D., F.A.C.S., Robert S. Jason M.D. (auth.)