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Penetrating Abdominal Trauma: Experience in A Teaching Hospital, Calabar, Southern Nigeria  [PDF]
Maurice Asuquo, Mark Umoh, Victor Nwagbara, Gabriel Ugare, Cyril Agbor, Emmanuel Japhet
International Journal of Clinical Medicine (IJCM) , 2012, DOI: 10.4236/ijcm.2012.35079
Abstract: Background: Penetrating abdominal trauma (PAT) typically involves the violation of the abdominal cavity by a gun-shot wound (GSW) or stab wound Recently several studies have favored a more conservative approach as opposed to mandatory exploratory laparotomy. Methods: Patients admitted in the University of Calabar Teaching Hospital (UCTH), Calabar, with PAT from January 2008 to December 2010 were prospectively studied based on a questionnaire. The total number of patients with PAT was compared with total number of emergencies, traumatic injuries and abdominal trauma seen during the same period. Results: A total of 48 patients presented with abdominal trauma: PAT 29 (60%) and blunt abdominal trauma (BAT) 19 (40%). The ages of the patients (28 male, 1 female) ranged from 3 - 62 years (mean 28.1 years). Gunshot wound (GSW) 11 (38%) patients, stab wound 8 (27.6%) patients and machete cut 4 (13.8%) patients ranked first, second and third respectively as causes of PAT. The commonest organ injury was perforation of the small intestine. Four (13.8%) patients were managed conservatively while 25 (86.2%) patients had laparotomy. The duration of admission ranged from 2 - 19 days (mean 10.5 days). Morbidity [surgical site infection (SSI)] and mortality were recorded in 2 (6.9%) and 3 (10.3%) patients respectively. Conclusion: Key areas that require attention have been highlighted. Revamping the ailing economy and gainful employment for youths are paramount areas that require prompt, dedicated and sustained intervention for reduction in violent crimes.
Hernia Following Blunt Abdominal Trauma
J Jaafari Nodooshan,N Aghaie,MH Maghsoodian,F Rahimi
Journal of Shahid Sadoughi University of Medical Sciences , 2009,
Abstract: Traumatic abdominal wall hernia is a rare type of hernia, which follows blunt trauma to the abdomen, where disruption of the musculature and fascia occurs with the overlying skin remaining intact. Diagnosis of this problem is very difficult and delayed. Traumatic hernia is often diagnosed during laparatomy or laparascopy, but CT scan also has a role in distinguishing this pathology. Delay in diagnosis is very dangerous and can result in gangrene and necrosis of the organs in the hernia. The case report of a 35 years old man with liftruck blunt trauma is reported. His vital signs were stable. On physical examination, tenderness of RUQ was seen. He underwent Dpl for suspected hemoprotein. Dpl was followed up by laparatomy. Laparatomy revealed that the transverse and ascending colon partially herniated in the abdominal wall defect. The colon was reduced in the abdomen and repair of abdominal hernia was done. The patient was discharged after 5 day. The etiology, pathogenesis and management are discussed.
Acute appendicitis after blunt abdominal trauma  [cached]
Marjan Joudi,Mehdi Fathi,Mehran Hiradfar
Zahedan Journal of Research in Medical Sciences , 2012,
Abstract: Appendecitis is one of the most frequent surgeries. Inflammation of appendix may be due to variable causes such as fecalit, hypertrophy of Peyer’s plaques, seeds of fruits and parasites. In this study we presented an uncommon type of appendicitis which occurred after abdominal blunt trauma. In this article three children present who involved acute appendicitis after blunt abdominal trauma. These patients were 2 boys (5 and 6-year-old) and one girl (8-year-old) who after blunt abdominal trauma admitted to the hospital with abdominal pain and symptoms of acute abdomen and appendectomy had been done for them.Trauma can induce intramural hematoma at appendix process and may cause appendicitis. Therefore, physicians should be aware of appendicitis after blunt abdominal trauma
Isolated duodenal rupture due to blunt abdominal trauma  [cached]
Celik Atilla,Altinli Ediz,Onur Ender,Sumer Aziz
Indian Journal of Critical Care Medicine , 2006,
Abstract: Duodenal rupture following blunt abdominal trauma is rare and it usually seen with other abdominal organ injuries. It represents approximately 2% to 20% of patients with blunt abdominal injury and often occurs after blows to the upper abdomen, or abdominal compression from high-riding seat belts. Two cases of blunt duodenal rupture successfully treated surgically, are presented with their preoperative diagnosis and final out comes.
Diagnostic Accuracy of Ultrasonography in Blunt Abdominal Trauma
A. Mohammadi,M.H. Daghighi,M. Poorisa,K. Afrasiabi
Iranian Journal of Radiology , 2008,
Abstract: Background/Objective: Patients in unstable clinical conditions with blunt abdominal trauma require rapid evaluation of the abdominal organ injury to assess the need for laparatomy. This prospective study was conducted to determine the use of emergency sonography for evaluating patients with blunt abdominal trauma and to compare the accuracy of sonography with the results of diagnostic peritoneal lavage (DPL), exploratory laparatomy and CT"nscan."nPatients and Methods: Emergency sonography was performed prior to any of the diagnostic methods, peritoneal lavage, exploratory laparatomy and CT, on 204 patients with blunt abdominal trauma. Sonography was performed with the "focused abdominal sonography for trauma" (FAST) technique and six areas of the abdomen were examined to detect free peritoneal fluid."nResults: Sonography showed a sensitivity of 95.4%, specificity of 78.4% and an overall accuracy of 89% in the diagnosis of free peritoneal fluid. The positive and negative predictive values of sonography were 89.2% and 90.6%, respectively."nConclusion: Sonography is a reliable and accurate method for the emergency evaluation of blunt abdominal trauma.
The Diagnostic Value of Ultrasonography in Patients with Blunt Abdominal Trauma  [cached]
Havva ?ahin,Fatih Tanr?verdi,Neriman Defne Alt?nta?
Journal of Academic Emergency Medicine , 2011,
Abstract: Objective: To evaluate the diagnostic value of ultrasonography (US) in detecting intraabdominal injuries in patients presenting with blunt abdominal trauma.Materials and Methods: All patients admitted to the emergency department with blunt abdominal trauma in 2009 were retrospectively evaluated. Records of clinical examinations, US reports and computed tomography (CT) findings were evaluated. Sensitivity, specificity, positive and negative predictive values for detecting abdominal free fluid and/or intraabdominal solid organ injury with US were determined. Results: A total of 110 patients with blunt abdominal trauma who underwent both US and CT were included in the study. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of US in detecting abdominal free fluid were 100%, 85.4%, 50%, 100% and 87.3%, respectively. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of US in detecting intraabdominal solid organ injury were 15.6%, 0.00%, 41.2%, 0.00% and 12.7%, respectively. Conclusion: When screening patients with blunt abdominal trauma, US has a high diagnostic performance after clinical evaluation, particularly for determining abdominal free fluid. However, it is not sufficiently successful in detecting intraabdominal solid organ injury.
Isolated jejunal perforation following blunt abdominal trauma  [PDF]
Ahmet Pergel,Remzi Adnan Akdo?an,?brahim Ayd?n
Dicle Medical Journal , 2012,
Abstract: Isolated perforation of the jejunum, following blunt abdominaltrauma, is extremely rare. These injuries aredifficult to diagnose because initial clinical signs are frequentlynonspecific and a delay in treatment increasesmortality and morbidity of the patients. Conventional radiogramsare often inadequate for diagnosing this subsetof trauma. For an accurate and timely diagnosis, thepossibility of bowel perforation and the need for repeatedexaminations should be kept in mind. Herein, we presenta 28-year-old man with isolated jejunal perforation followingblunt abdominal trauma.Key words: Blunt abdominal trauma, isolated jejunal perforation,early diagnosis
NonOperative Management of Blunt Solid Abdominal Organ Injury in Calabar, Nigeria  [PDF]
Asuquo Maurice, Bassey Okon, Etiuma Anietimfon, Ngim Ogbu, Ugare Gabriel, Anthonia Ikpeme
International Journal of Clinical Medicine (IJCM) , 2010, DOI: 10.4236/ijcm.2010.11006
Abstract: Background: Over the past several years, nonoperative management has been increasingly recommended for the care of selected blunt abdominal trauma patients with solid organ injuries. Objective: To evaluate the pattern and outcome of blunt abdominal trauma using haemodynamic stability and ultrasonography in the selection of patients for nonoperative management in a facility without computed tomogram. Methods: Patients admitted with blunt abdominal trauma between February 2005 and January 2010 were prospectively studied. Haemodynamic stability and sonography formed the basis for selecting patients for nonoperative management. Results: In total, 58 patients suffered blunt abdominal trauma and 19(33%) patients were successfully managed nonoperatively suffered blunt solid abdominal organ injuries. Road traffic accidents inflicted 17(89%) patients while 2(11%) patients sustained sports injury (football). The spleen was the commonest solid organ injured 12(60%), while the liver and kidney were injured in 6(30%) and 2(10%) respectively. Associated injuries were fractured left femur recorded in 3(16%) patients and fractured rib in a patient (5%). Conclusion: Nonoperative treatment is a safe and effective method in the management of haemodynamically stable patient with blunt solid abdominal organ injury. This translated to a reduction in hospital stay, absence of the risk of blood transfusion as well as attendant morbidity and mortality associated with laparotomy. Establishment of trauma system, provision of diagnostic and monitoring facilities, good roads, and education on road safety is recommended for improved outcome.
Gastrointestinal Injuries Following Blunt Abdominal Trauma In Children
LB Chirdan, AF Uba, OO Chirdan
Nigerian Journal of Clinical Practice , 2008,
Abstract: Purpose: Gastrointestinal (GI) injuries in children following blunt abdominal trauma is rare; early diagnosis and treatment is important for good outcome. The purpose of this report is to describe the management problems encountered in children with GI injuries following blunt abdominal trauma. Patients and Methods: From January 1996 June 2006, 168 children were treated at our centre for abdominal trauma. Twenty three had GI injuries, 19 were due to blunt trauma while four were due to penetrating trauma. We retrospectively reviewed the clinical data of the 19 children that had GI injuries as a result of blunt abdominal trauma to document the presentation, clinical features, diagnosis and outcome. Results: There were 19 patients, 14 were boys, and five were girls. The median age at presentation was nine years (range 1.5 15 years). Road traffic accident was responsible for injuries in 10, fall from heights in six and assault in two children. In one child the cause of injury was not recorded. Most children presented late and at presentation over 80% had abdominal signs. Diagnosis was mainly by physical examination supported by plain abdominal x-ray in 15 children. All 19 children had laparotomy. There were a total of 23 injuries. Gastric and duodenal injuries accounted for one each. Most of the injuries were in the jejunum and ileum (10 perforations, two contusions with one mesenteric haematoma and one mesenteric tear). There was one caecal perforation and six colonic injuries , one of which was associated with intraperitoneal rectal injury. Five children had other associated injuries (three splenic injuries, one renal injury, one bladder contusion associated with long bone fractures and one severe closed head injury). Treatment included segmental resection with end to end anastomosis, wedge resection with anastomosis, exteriorizations stomas, simple excision of the perforation and closure in two layers (gastric perforation). The total mortality was four (21.1%), two of them due to associated injuries. Conclusion: Gastrointestinal injuries due to blunt abdominal trauma pose a management challenge. Management based on decisions from serial clinical examinations and simple tests without recourse to advance imaging techniques may suffice.
Results of Surgical Treatment of Patients with Liver Laceration from Blunt Abdominal Trauma  [PDF]
Alexei L. Charyshkin, PhD, ScD,Michael R. Gafiullov,Vladimir P. Demin
International Journal of BioMedicine , 2012,
Abstract: In this paper, the method developed to suture liver wounds is described in detail. The results of the surgical treatment of liver laceration with blunt abdominal trauma during the period 2001-2012 are presented. The technique developed for suturing liver wounds in patients with blunt abdominal trauma was evaluated. The method developed involving suturing of the liver wounds in patients with blunt abdominal trauma contributes to reliable hemostasis, significantly reduces the duration of surgery and the development of post-operative complications.
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