To see the other types of publications on this topic, follow the link: Hollow viscus injuries.
Journal articles on the topic 'Hollow viscus injuries'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Hollow viscus injuries.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Oncel, Didem, Darren Malinoski, Carlos Brown, Demetrios Demetriades, and Ali Salim. "Blunt Gastric Injuries." American Surgeon 73, no. 9 (2007): 880–83. http://dx.doi.org/10.1177/000313480707300910.
Full textAbstract:
Gastric rupture after blunt abdominal trauma is a rare injury with few reports in the literature. The purpose of this study was to review our experience with blunt gastric injuries and compare outcomes with small bowel or colon injuries. All patients with hollow viscus perforations after blunt abdominal trauma from 1992 to 2005 at our level I trauma center were reviewed. Of 35,033 blunt trauma admissions, there were 268 (0.7%) patients with a total of 319 perforating hollow viscus injuries, 25 (0.07%) of which were blunt gastric injuries. When compared with the small bowel or colon injuries, the blunt gastric injury group had a higher Injury Severity Score (22 versus 17, P = 0.04), more patients with a chest Abbreviated Injury Score greater than 2 (36% versus 12%, P < 0.01), and a shorter interval from injury to laparotomy (221 versus 366 minutes, P = 0.017). Multivariate analysis identified five independent risk factors for mortality: age older than 55 years, head Abbreviated Injury Score greater than 2, chest Abbreviated Injury Score greater than 2, the presence of hypotension on admission, and Glasgow Coma Scale 8 or less. The results of this study suggest that mortality in patients with blunt hollow viscus injuries can be attributed to concurrent head and chest injuries, but not the specific hollow viscus organ that is injured.
2
Ajmeera Ranga and Kongara Rajesh. "Hollow Viscus Injuries Due To Trauma." Academia Journal of Surgery 3, no. 1 (2020): 163–66. http://dx.doi.org/10.47008/ajs/2020.3.1.35.
Full textAbstract:
Background: Hollow viscus injuries can be due to traffic accidents, fall from the height, and fall of heavy objects leading to trauma. Abdominal trauma is the most common with Injuries pertaining to Gastro-Intestinal tract from the cardiac end of the esophagus to the anus, gall bladder, and biliary tract and lower genitourinary tract. The aim of the study is to study the modes of trauma, clinical features of hollow viscus injuries, and the diagnosis and management of hollow viscus injuries. Subjects and Methods: This was a hospital-based cross-sectional study. conducted over a period of one year from June 2018 – May 2019. at Department of General Surgery on 90 patients with hollow viscus injury. After initial resuscitation of the trauma victims, a careful history was taken to document any associated medical problem. The collected data was analyzed with respect to the presentation by the patient’s age and sex incidence, etiologies, pathological features, morbidity, and mortality associated with causation and management. The ultrasound and CT- Scan were done to assess the injury and plan accordingly before taking up for the surgery. Results: The majority of the patients belonged to the age group of 21 – 30 years and the least pertaining to the age group of 41 – 50 years of age group. The Incidence in Males is much more than females. The males were 74% and females were 26%. The most common causative agent of hollow viscous injury was a Road traffic accident with 59%. Majority of the patients who were admitted more than 24 hours after the injury, the mortality rate was much higher compared to the patients who were admitted in less than 24 hours of the trauma. Conclusion: HVI is a dangerous condition. High mortality rates represent the seriousness of HVI and related injuries. Patients of HVI should be carefully monitored for associated injuries and complications.
3
Jyotirmaya, Nayak, Kumar Rajsamant Nagendra, Panda Sridhar, and Patra Gopabandhu. "Hollow Viscus Injuries in Abdominal Trauma: A Clinical Study." International Journal of Pharmaceutical and Clinical Research 15, no. 12 (2023): 122–27. https://doi.org/10.5281/zenodo.11185024.
Full textAbstract:
<strong>Background and goals: </strong>To investigate the incidence of abdominal trauma. The incidence of blunt and penetrating abdominal trauma-induced hollow viscus lesions is investigated in this study. Demographics such as age and gender will also assist us understand stomach injury symptoms. Determine the duration between injury and surgery, as well as the effectiveness of treatment approaches. <strong>Methods: </strong>Between October 2021 and September 2022, 65 patients sought emergency care at the Department of General Surgery, SCB Medical college, cuttack for blunt or penetrating abdominal trauma caused by automobile accidents, attacks with various objects, acts of interpersonal violence, or unintentional falls. Those who had significant abdominal pain but exhibited no evidence of hollow viscus injury on imaging or after surgery were eliminated. <strong>Results: </strong>The starting factor declined with age, with 18 individuals aged 31 to 40 and 12 aged 41 to 50. 56 of the 65 patients were males, showing that men are more likely to be injured as a result of violence. 78 percent of the 65 patients with hollow viscus injuries had blunt trauma, whereas 13 had penetration. 25 of 42 patients had blunt hollow viscus injuries in car accidents, 9 from falls, and 8 from assaults. Of the 55 patients, 27 had primary perforation closure. Resection and anastomosis were necessary in 12 instances. Seven serosal tears mended without surgery. <strong>Conclusion: </strong>This research demonstrates that blunt abdominal trauma induces hollow viscus damage. As a result, patients with acute abdominal trauma should be assessed for hollow viscus damage. In dubious cases, extensive clinical testing, close observation, and further imaging are required to confirm the diagnosis and expedite surgery. The best restoration procedure is determined by age, intestinal pollution, underlying illnesses, and health. The most essential factors are surgeon skill and trauma center facilities.
4
Anup, Desai, Khan Ahmed, Patil Basvanth, and Shinde Nandkishore. "Outcome of Traumatic Hollow Viscus Injuries at Tertiary Care Center." International Journal of Pharmaceutical and Clinical Research 16, no. 3 (2024): 1250–55. https://doi.org/10.5281/zenodo.10972267.
Full textAbstract:
<strong>Background: </strong>Traumatic hollow viscous injuries following road traffic motor vehicle accidents are rising due to urbanisation, modernisation and it is the main cause of morbidity and mortality in Trauma. The aim of this study is to know the factors in traumatic hollow viscous injuries which help in decreasing mortality. <strong>Methods: </strong>Retrospectively records of all the patients with a history of abdominal trauma due to road traffic accidents and diagnosed as hollow viscous injuries on X-ray abdomen and/or Ultrasound (USG) or/and Computer tomography (CT) were analyzed. Demographic data, mode of injury, mechanism of injury, nature of the injury, presentation to the hospital, hemodynamic stability, investigations, definitive treatment required and the outcome of patients were recorded. <strong>Results: </strong>There were 32 patients of abdominal trauma with hollow viscous perforation with male to female ratio of 4.3:1. Mean age was 33.61±14.61 years.8 (25%) cases reached hospital 6 hours after abdominal injury. Blunt abdominal trauma was seen in 29 (90.6%) cases. Surgical interventions were required in all 32 (100%) cases. Most common were small bowel injuries (56.3%) followed by colon (25%). Surgical intervention in bowel consisted of laparotomy and simple closure of perforation in 12 (37.5%) patients, resection and anastomosis in 15 (46.88%) patients and stoma in 3 (9.3%). Closure of urinary bladder done in 2 (6.3%) patients. 3 patients (9.3%) of abdominal trauma with hollow viscous perforation succumbed to death. Among the factors leading to mortality, delayed presentation, hemodynamic instability, requirement of transfusion, resection and re-explorations were common. <strong>Conclusion: </strong>Delayed presentation and management, hemodynamic instability, site, mechanism of injury, resection and re-explorations are the factors deciding outcome in traumatic hollow viscus injuries.
5
Kokabi, Nima, Elie Harmouche, Minzhi Xing, et al. "Specific Radiological Findings of Traumatic Gastrointestinal Tract Injuries in Patients with Blunt Chest and Abdominal Trauma." Canadian Association of Radiologists Journal 66, no. 2 (2015): 158–63. http://dx.doi.org/10.1016/j.carj.2014.11.003.
Full textAbstract:
Gastrointestinal hollow viscus injury after blunt chest and abdominal trauma is uncommon and complicates 0.6%-1.2% of all cases of trauma. Early recognition of such injuries significantly decreases morbidity and mortality. Since physical examination is not accurate in detecting such injuries, contrast-enhanced computed tomography has been the mainstay for diagnosis in many emergency departments. This pictorial essay aims to review the incidence, mechanisms, and signs of gastrointestinal hollow viscus injuries in the setting of blunt chest and abdominal trauma.
6
Deepak, Jadhav Maloth, Shyam V, Anil Kumar Bushigampala, and Shiva Kumar Kyasa. "Hollow Viscus Injuries in Abdominal Trauma: A Prospective Study." International Journal of Pharmaceutical and Clinical Research 15, no. 12 (2023): 720–24. https://doi.org/10.5281/zenodo.11193119.
Full textAbstract:
<strong>Introduction:</strong> Abdominal organ injuries are the third most common injuries encountered after head and chest injuries. Hollow viscus injuries are not less common and are equally or more life threatening than solid visceral injuries accounting to more blood loss and contaminating bowel injuries. <strong>Aim and Objectives:</strong> To study hollow viscus injury in the cases of abdominal trauma patients. <strong>Materials and Method:</strong> This study was a prospective observational study includes 68 patients admitted in the casualty ward, of Chalmeda Anand Rao institute of medical sciences, Karimnagar, with abdominal trauma both blunt and penetrating injuries following road traffic accidents, assault by various objects, interpersonal violence and accidental falls during the period of one year after following inclusion and exclusion criteria and after approved from institutional ethical committee. <strong>Results:</strong> In the study out of 68 patients, patients with age group between 12 to 70 years, majority of the patients were from the age group of 16 to 45 years. most frequent cause of blunt abdominal injuries was automobile accidents (61.8%), abdominal pain was the most prevalent symptom in the current study (61%). Jejunum, and Ileum was most commonly involved followed by gall bladder, urinary bladder and colon. wound infection is the most common complication seen in 10 patients (14%). Mortality is this study was 7.35%. <strong>Conclusion:</strong> Blunt or penetrating abdominal trauma causes hollow viscus injuries in the stomach, small intestine, colon, rectum, gall bladder, and urine bladder. Trauma can produce anything from a little bruise to a life-threatening loss of blood.
7
Niederee, Mark J., Matthew C. Byrnes, Stephen D. Helmer, and R. Stephen Smith. "Delay in Diagnosis of Hollow Viscus Injuries: Effect on Outcome." American Surgeon 69, no. 4 (2003): 293–99. http://dx.doi.org/10.1177/000313480306900404.
Full textAbstract:
Delay in the recognition of hollow viscus injury may lead to increased morbidity and mortality. Unfortunately the early diagnosis of these injuries remains a diagnostic challenge increasing the likelihood of delay. Patients transferred to Level I trauma centers from outlying institutions may be at increased risk of morbidity from hollow viscus injury, as there is an inherent delay associated with transfer. Herein we reviewed our institution's 11-year experience with the diagnosis and treatment of hollow viscus injury caused by blunt mechanism. Forty-one patients met defined criteria of hollow viscus injury. Patients were stratified into two groups: interval to operating room ≤24 hours versus >24 hours. Length of hospital stay, number of ventilator days, and percentage of patients developing acute respiratory distress syndrome were significantly greater in the >24-hour group. Mortality was not significantly different between the groups (26.7% vs 36.4%). Patients transferred from other institutions were more likely to experience complications and operative delay. In conclusion delay in operative intervention (>24 hours) adversely affected outcomes. Early transfer of patients to Level I trauma centers may improve outcomes. A high index of suspicion and the use of multiple diagnostic modalities may lead to earlier operative treatment and improved outcome.
8
Sharon Rose, William Premalatha, Ravikumar Sumathi, and Dhanasekaran Uma. "PROSPECTIVE STUDY ON TRAUMATIC HOLLOW VISCUS INJURIES." Journal of Evidence Based Medicine and Healthcare 4, no. 36 (2017): 2179–83. http://dx.doi.org/10.18410/jebmh/2017/427.
Full text
9
Bhagwan, Raghunath Korde, and U. Chandak Nihar. "An Exploratory Study of Traumatic Hollow Viscus Injuries." International Journal of Pharmaceutical and Clinical Research 15, no. 8 (2023): 1658–63. https://doi.org/10.5281/zenodo.11528962.
Full textAbstract:
<strong>Background: </strong>Trauma is a serious health issue in every country, and it sadly accounts for 60–70% of all emergency hospital admissions. Patients who have suffered trauma require the highest level of treatment since they can often be saved the most. For patients between the ages of 12 and 45, traumatic injuries continue to be the primary cause of death and a significant cause of morbidity. Following blunt abdominal trauma, hollow viscus damage is a rare diagnosis. Injuries to the hollow viscus that occur after abdominal trauma range from 2 to 15% in frequency. Traumatic hollow viscus and mesenteric injury (HVMI) has a high mortality and complication rate despite its rarity. Regarding its ideal management, there is no agreement. Hollow viscus injuries (HVIs) have a significant mortality and morbidity rate, however they are a rare but potentially fatal disorder. There are other ceCT scan criteria that have been published for the diagnosis of HVMI, however none of them have, as of yet, been linked to adequate sensitivity and specificity when assessed separately. <strong>Aim:</strong> The aim of this study was to analyze patients undergoing surgery for blunt or penetrating bowel trauma to identify prognostic factors with particular attention to the influence of diagnostic delay on outcome. <strong>Material and Method: </strong>In the Department of General Surgery, a prospective, nonrandomized, descriptive study was done. Patients present across a wide variety of ages, with the youngest patient being 16 years old and the oldest patient being 65. written authorization signed by the patient or their trusted caregivers after receiving full disclosure. The study included all patients with brutal and penetrating injuries who underwent a pre-operative ceCT followed by a laparotomy. A 64 detector multirow scanner was used to do the multiphasic torso ceCT scan from the base of the skull to the pubis. The contrast agent was injected at a rate of 3–4 ml/sec at 1.7 ml/kg body weight. Pre-contrast, arterial phase with trigger at 150 HU in the thoracic aorta, and venous phase were the three phases of the protocol that were used. Patients who agreed to participate in the trial with their guardians’ permission provided signed informed consent. <strong>Results: </strong>The values of ceCT and of a single ceCT criteria for substantial HVMI requiring surgical correction in terms of sensitivity, specificity, predictive values, likelihood ratios, and accuracy. With at least one affirmative criterion, preoperative ceCT demonstrated strong sensitivity and a low incidence of false negative instances. The more diagnostic criteria for HVMI there are, the higher the ceCT’s positive predictive value becomes. Patients with HVMI were more likely to be men and had more serious thoracic injuries. The most common condition in cases of multiple intestinal traumas was the combination of colon and mesenteric injuries. <strong>Conclusion: </strong>In conclusion, when combined with a specific clinical observation, evolving technologies and skill have rendered ceCT in trauma both a viable exam to choose patients for surgical exploration when several criteria are present and a reliable screening test to exclude serious HVMI. Further prospective studies are necessary to better establish not only the diagnostic capacity of ceCT on HVMI but also the capacity to link imaging results with appropriate treatment indications given the significance of these results on the management of trauma patients.
10
Nishit R Santoki, Pranjal Sangole, and Gyaneshwar Rao. "Evaluation of the Viscus injury in Abdominal Trauma." Academia Journal of Surgery 3, no. 1 (2020): 56–58. http://dx.doi.org/10.47008/ajs/2020.3.1.12.
Full textAbstract:
Background: The diagnosis of hollow viscus injury with advanced diagnostic tools and management of trauma by conservative and surgically by laparotomy and correction of anatomy. Hence such injuries are frequently overlooked leading to increased morbidity and mortality. Thus, this study is intended to throw light upon the prompt diagnosis and management of hollow viscus injuries in trauma. Hence the aim of the present research was to study the diagnosis and management of hollow viscus injuries. Subjects and Methods: A total of 100 cases were included in the study. All the patients were above the age of 11 years and maximum age of 80 years. Most of the patients included were male with ration of 4:1. After recording of history clinical examination followed by radiological, serological and operative findings were recorded. Data was analyse to study the male: female ratio, etiologies of viscous injury, investigation done and possible management for the treatment. Results: On analysis of the data, most common reason for the abdominal trauma was found to be road traffic accident followed by stab injury. The maximum of the patients belong to the age group of 2 to 30 years. Most common reason for the abdominal trauma was found to be road traffic accident followed by stab injury. Conclusion: It is mostly seen in the age group of 21-30 years which form the young and reproductive group. These patients’ measures should be taken to prevent these accidents and care of victims at the accident site. Well established trauma care centers should be established at least at every taluk hospital. Measures for early transport of the patients from the accident site to the trauma care centres to be undertaken.
11
Ordoñez, Carlos Alberto, Michael Parra, Yaset Caicedo, et al. "Damage control surgical management of combined small and large bowel injuries in penetrating trauma: Are ostomies still pertinent?" Colombia Medica 52, no. 2 (2021): e4114425. http://dx.doi.org/10.25100/cm.v52i2.4425.
Full textAbstract:
Hollow viscus injuries represent a significant portion of overall lesions sustained during penetrating trauma. Currently, isolated small or large bowel injuries are commonly managed via primary anastomosis in patients undergoing definitive laparotomy or deferred anastomosis in patients requiring damage control surgery. The traditional surgical dogma of ostomy has proven to be unnecessary and, in many instances, actually increases morbidity. The aim of this article is to delineate the experience obtained in the management of combined hollow viscus injuries of patients suffering from penetrating trauma. We sought out to determine if primary and/or deferred bowel injury repair via anastomosis is the preferred surgical course in patients suffering from combined small and large bowel penetrating injuries. Our experience shows that more than 90% of all combined penetrating bowel injuries can be managed via primary or deferred anastomosis, even in the most severe cases requiring the application of damage control principles. Applying this strategy, the overall need for an ostomy (primary or deferred) could be reduced to less than 10%.
12
Sarker, Ashok Kumar, and Hasnat Zaman Zim. "Management of Hollow Viscus Injury following Gunshot at Casualty Department of Dhaka Medical College & Hospital." Journal of Enam Medical College 9, no. 2 (2019): 110–15. http://dx.doi.org/10.3329/jemc.v9i2.41413.
Full textAbstract:
Background: Gunshot injuries result from the effect of a bullet or projectiles emanating from the use of firearms. Firearm injuries are associated with substantial emotional, physical and financial burden causing an enormous human toll and imposing huge costs on the society. Abdominal injuries are associated with a high incidence of internal injury. These injuries are increasingly seen in many developing countries, which have been attributed to communal and ethnic clashes, political violence and armed robberies.
 Objective: The objective of this study was to determine the overall outcome of hollow viscus injury following gunshot on the basis of time duration of presentation and amount of blood loss at the time of presentation.
 Materials and Methods: This observational study was conducted at casualty department of Dhaka Medical College & Hospital over a period of one year from October 2014 to October 2015. All admitted patients with hollow viscus injury due to gun shot at casualty department of DMCH were included in this study by selective sampling technique. The main outcome variables were postoperative wound infection, anastomotic leakage, number of deaths and prolonged hospital stays. Data processing and analysis were done using SPSS 17.0.
 Results: There were total 76 patients with hollow viscus injury following gunshot during the period under review. All were male patients with mean age 31.13 years. Peak incidence occurred within age group 41–60 (52.6%). The most commonly injured organs were the small bowel in 34 patients (44.7%). Thirty (90.9%) patients presented within three hours of the event (p=0.001). Among six patients who died, 5 (83.8%) presented 10 hours after the event (p=0.001). Among 20 patients, 18 (90%) remained hospitalized more than 15 days, who presented within 4–6 hours of the event (p=0.001). In 29 out of 33 patients (87.9%) who did not suffer from any complications encountered only less than 15% of blood loss at the time of presentation (p=0.001). Among 15 patients who suffered from postoperative wound infection nine patients (60%) lost 30–40% of blood at the time of presentation (p=0.011).
 Conclusion: Outcome of the patients with hollow viscus injury following gunshot were found to be related to the time taken to reach the casualty department from the place of event and the amount of blood loss at the time of presentation.
 J Enam Med Col 2019; 9(2): 110-115
13
Singh, Santosh Kumar, and Deepak Mittal. "Abdominal blunt trauma in children: experience from a single center." International Surgery Journal 6, no. 8 (2019): 2885. http://dx.doi.org/10.18203/2349-2902.isj20193336.
Full textAbstract:
Background: Abdominal blunt trauma (ABT) remains an important cause of childhood morbidity and sometimes, mortality. Recently the approach for management of ABT has tilted towards conservative one with excellent results. In this study, we present our experience of ABT from a teaching hospital.Methods: All patients below 17 years with ABT between December 2012 and May 2016 were studied retrospectively and methods and results analyzed.Results: A total of 33 patients presented with ABT, mainly due to fall from height or road-traffic accidents. Age ranged from 3 to17 years. Of the 33 patients, 30 patients had solid organ injuries and only 3 patients had isolated hollow viscus injuries. Operative intervention was needed in 6 (18.2%) patients, of whom three needed upfront surgery. They had had hollow viscus injury. Others who developed signs and symptoms of other injuries included duodenal injury, ureteric transection and delayed adhesive intestinal obstruction following bile leak, one each. Average hospital stay of patients with solid organ injury was 5.4±1.6 days while for those with hollow viscus injury requiring operative intervention, this was 12.3±2.4 days. There was no mortality.Conclusions: ABT is a frequent emergency in children in the developing world. Prompt initial management significantly affects the eventual outcome. Imaging studies are the cornerstone of diagnosing the type and extent of injury. Most patients can be managed conservatively. However, constant masterly vigilance is needed to pick up the evolving signs, thereby avoiding possible complications and morbidity.
14
Holloway, Janell, Lanair Amaad Lett, Lobsang Marcia, et al. "Primary Skin Closure after Repair of Hollow Viscus Injuries." American Surgeon 85, no. 10 (2019): 1139–41. http://dx.doi.org/10.1177/000313481908501013.
Full textAbstract:
Decisions regarding whether to close the skin in trauma patients with hollow viscus injuries (HVIs) are based on surgeon discretion and the perceived risk for an SSI. We hypothesized that leaving the skin open would result in fewer wound complications in patients with HVIs. We performed a retrospective analysis of all adult patients who underwent operative repair of an HVI. The main outcome measure was superficial or deep SSIs. Of 141 patients, 38 (27%) had HVIs. Twenty-six patients developed SSIs, of which 13 (50%) were superficial or deep SSIs. On adjusted analysis, only female gender ( P = 0.03) and base deficit were associated ( P = 0.001) with wound infections Open wound management was not associated with a decreased incidence of SSIs ( P = 0.19) in patients with HVIs. Further research is required to determine optimal strategies for reducing wound complications in patients sustaining HVIs.
15
Varma Gunturi, Surya Ramachandra, Venu Madhav Thumma, Jagan Mohan Reddy Bathalapalli, et al. "Hollow viscus injury due to blunt abdominal trauma." International Surgery Journal 4, no. 3 (2017): 861. http://dx.doi.org/10.18203/2349-2902.isj20170429.
Full textAbstract:
Background: Management of hollow viscus injury (HVI) due to blunt abdominal trauma (BAT) is a challenge to the clinicians even in the era of advanced imaging and enhanced critical care. Repeated clinical examination with appropriate imaging with multidisciplinary teamwork is the key for timely intervention in equivocal cases for successful outcomes. Aim of the study was to present our experience over last 4½ years.Methods: This is a retrospective study of prospectively collected data of patients treated at surgical gastroenterology department, Nizam’s Institute of Medical Sciences, Hyderabad, India over a period of 4½ years (2012-2016).Results: A total of 126 BAT Patients were treated in our unit as inpatients during the last 4½ years. Out of 126, twenty patients (15.87%) with HVI in whom surgical intervention was done formed the study group. Contrast enhanced CT Scan abdomen and chest was done in stable patients (13/20), in rest of the patients (7/20) the decision to operate was taken more on clinical grounds along with X-ray abdomen and USG abdomen features. 12 (60%) had jejunal and ileal injuries, 5 (25%) patients had colonic injuries (sigmoid 4, caecum 1). One (5%) patient had extra peritoneal rectal perforation with ascending retroperitoneal fascitis and 2 (10%) had duodenal injury. Two (10%)patients required relaparotomy. We had mortality in 3 (15%) patients and 17 (85%) patients had complete recovery.Conclusions: Hollow viscus injury should be suspected in all cases of blunt abdominal trauma. In equivocal cases careful repeat clinical examinations with close monitoring and repeat imaging is highly essential to prevent delay in intervention. Type of procedure is based on time of presentation, degree of contamination, associated injuries and general condition of the patient.
16
Paulus, Elena M., Martin A. Croce, Charles P. Shahan, et al. "Synergistic Effect of Combined Hollow Viscus Injuries on Intra-Abdominal Abscess Formation." American Surgeon 81, no. 7 (2015): 674–78. http://dx.doi.org/10.1177/000313481508100715.
Full textAbstract:
The strong association between penetrating colon injuries and intra-abdominal abscess (IAA) formation is well established and attributed to high colon bacterial counts. Since trauma patients are rarely fasting at injury, stomach and small bowel colony counts are also elevated. We hypothesized that there is a synergistic effect of increased IAA formation with concomitant stomach and/or colon injuries when compared to small bowel injuries alone. Consecutive patients at a level one trauma center with penetrating small bowel (SB), stomach (S), and/or colon (C) injuries from 1996 to 2012 were reviewed. Logistic regression determined associations with IAA, adjusting for age, gender, Injury Severity Score (ISS), admission Glasgow Coma Score, transfusions, and concurrent pancreas or liver injury. A total of 1518 patients (91% male, ISS = 15.9 ± 8.4) were identified: 496 (33%) SB, 231 (15%) S, 288 (19%) C, 40 (3%) S + SB, 69 (5%) S + C, 338 (22%) C + SB, and 56 (4%) S + C + SB. 148 (10%) patients developed IAA: 4 per cent SB, 9 per cent S, 10 per cent C, 5 per cent S + SB, 22 per cent S + C, 13 per cent C + SB, and 25 per cent S + C + SB. Multiple logistic regression demonstrated that ISS, 24 hour blood transfusions, and concomitant pancreatic or liver injuries were associated with IAA. Compared with reference SB, S or S + SB injuries were no more likely to develop IAA. However, S + C, SB + C, and S + C + SB injuries were significantly more likely to have IAA. In conclusion, combined stomach + colon, small bowel + colon, and stomach, colon, + small bowel injuries have a synergistic effect leading to increased IAA formation after penetrating injuries. Heightened clinical suspicion for IAA formation is necessary in these combined hollow viscus injury patients.
17
Nihir, Gupta, Nagar Anju, Meena Dharmraj, Meena Anshul, Singh Juhi, and Meena Radheyshyam. "Hollow Viscus Injuries in Abdominal Trauma: An Observational Clinical Study." International Journal of Toxicological and Pharmacological Research 13, no. 5 (2023): 213–19. https://doi.org/10.5281/zenodo.11212618.
Full textAbstract:
<strong>Background:</strong> In today’s highly developed civilised society, trauma is thought to be the main factor contributing to morbidity and mortality. <strong>Methods:</strong> In the current study, 50 cases of abdominal trauma (including blunt and penetrating wounds) were examined over a 12-month period in our institute. <strong>Results:</strong> Males between the ages of 21 and 30 were most frequently impacted. Injury from a car accident is the most frequent type. 93% of patients experienced abdominal pain, and 86% report tenderness. An upright abdomen plain x-ray was effective at spotting hollow viscus damage. An ultrasound examination clearly showed free fluid and solid organ damage. Small bowel was the viscera that was most frequently injured in this study, and it was treated with straightforward anastomosis, resection, and closure of perforations. There were postoperative issues such wound infection, wound dehiscence, respiratory issues, pelvic abscess, and faecal fistula. Most of the patients in this study stayed between 11 and 20 days, with a mean of 15 days. In this trial, mortality was 4%. <strong>Conclusions:</strong> Young boys are most frequently impacted by traffic accidents. The prognosis for penetrating abdominal trauma is made worse by factors such as small bowel injury, long time between injury and operation, presence of shock at admission, and female gender.
18
Matlock, Kinzie A., Alan H. Tyroch, Ziad N. Kronfol, Susan F. McLean, and Miguel A. Pirela-Cruz. "Blunt Traumatic Bladder Rupture: A 10-year Perspective." American Surgeon 79, no. 6 (2013): 589–93. http://dx.doi.org/10.1177/000313481307900619.
Full textAbstract:
The purpose of this study was to determine the incidence, features, and associated injuries of intraperitoneal (IP) and extraperitoneal (EP) bladder rupture (BR) resulting from blunt trauma. A retrospective study from September 2001 to August 2011 was performed for blunt traumatic BR in adults. Demographics, mean Injury Severity Score (ISS), mean length of stay (LOS), incidence, mortality, operative repair, and associated injuries were evaluated. Of 15,168 adult blunt trauma admissions over 10 years, 54 patients had BR (EP = 22, IP = 27, EP + IP = 5; incidence = 0.36%). Sixty-three per cent were male. The mean age, ISS, and LOS were 40 years, 29, and 15 days, respectively. The mortality rate was 11 per cent. Fifty-two per cent of BR was the result of a motor vehicle crash. Most BRs were diagnosed by computed tomography cystogram. Eighty per cent had pelvic fracture. Hollow viscus injury was present in 34.5 per cent of patients. Colonic injury was seen in 24 per cent and 9.3 per cent had a rectal injury. Although BR is rare in adult blunt trauma, it is associated with high ISS, LOS, and mortality. Pelvic fractures are essentially present in all patients with EP BR. Hollow viscus injuries, especially colonic and rectal injuries, are more prominent in IP BR.
19
Beierle, Elizabeth A., Mike K. Chen, Max R. Langham, David W. Kays, and James L. Talbert. "Small Watercraft Injuries in Children." American Surgeon 68, no. 6 (2002): 535–38. http://dx.doi.org/10.1177/000313480206800606.
Full textAbstract:
The speed and use of small watercraft have increased dramatically in recent years. We report our experience with pediatric trauma resulting from small watercraft accidents. We conducted a retrospective chart review including all children admitted with injuries sustained in small watercraft accidents. Sixteen children were included; nine were injured in jet ski accidents and seven in accidents involving other craft. Jet ski accidents tended to result in more serious injuries (closed-head injuries, hollow and solid viscus injuries, chest trauma, spinal injuries leading to paralysis, and death) than those sustained in accidents with small boats. Skin and soft-tissue injuries and long-bone fractures were the most frequent injuries following accidents with other small boats. Six of eight children (75%) injured on jet skis required operative interventions. Only three of seven (43%) children in other watercraft accidents required surgery ( P < 0.05 jet ski vs other watercraft). When compared with children injured in accidents involving small boats those involved in jet ski accidents tended to have more serious injuries and require operative intervention more frequently. A high index of suspicion for serious injuries must be maintained when evaluating children with this mechanism of injury.
20
Mingoli, Andrea, Marco La Torre, Gioia Brachini, et al. "Hollow viscus injuries: predictors of outcome and role of diagnostic delay." Therapeutics and Clinical Risk Management Volume 13 (August 2017): 1069–76. http://dx.doi.org/10.2147/tcrm.s136125.
Full text
21
Harris, Brady T., Glen A. Franklin, Brian G. Harbrecht, and J. David Richardson. "Impact of Hollow Viscus Injuries on Outcome of Abdominal Gunshot Wounds." American Surgeon 75, no. 5 (2009): 378–84. http://dx.doi.org/10.1177/000313480907500506.
Full textAbstract:
Abdominal gunshot wounds (GSW) are a source of morbidity and mortality. Limited data are available on the effect of hollow viscus injuries (HVI) secondary to gunshot wounds. GSW sustained in the Louisville area from 2004 to 2007 were reviewed. Attention was given to the impact of HVI from abdominal GSW. Statistical significance was determined. One-hundred ten patients sustained GSW with peritoneal violation. Eighty-six had HVI. Eighteen died after laparotomy with 15 having an HVI. Patients undergoing damage control (DC) have a significant increase in mortality compared with those not requiring DC. Exsanguination was the major cause of mortality (67%). Mortality directly related to HVI was found in 11 per cent. Twenty patients underwent DC with 11 deaths. Isolated HVI did not show a significantly increased mortality compared with other injury patterns involving solid organ or major vascular structures. Various methods of repair showed no significant survival advantage. Recognition and repair of HVI in abdominal GSW is crucial to patient salvage. Definitive repair of HVI at the initial operation should be considered. Primary repair of HVI is preferred although no survival disadvantage is seen in other forms of repair in marginally stable patients. Definitive repair at the initial operation decreases complications.
22
Jain, Sanjay, Dinkar Maske, and M. C. Songra. "Clinical study of hollow viscus injury in abdominal trauma." International Surgery Journal 5, no. 1 (2017): 39. http://dx.doi.org/10.18203/2349-2902.isj20175521.
Full textAbstract:
Background: Abdominal injury is leading cause of morbidity and mortality at present due to great improvement in man's lifestyle and development of industries.Methods: A total 100 cases of abdominal trauma (both blunt and penetrating) were studied in the present study in our institute for period of 18 Months.Results: Males belonging to young age group of 21-30 were most commonly affected. Road traffic accident is most common mode of injury. Abdominal pain seen in 93% of patients. Abdominal tenderness seen in 86% of patients. Plain x ray abdomen erect was sensitive in detecting hollow viscus injuries. Diagnostic peritoneal lavage is better than four quadrant aspirations. Ultrasound examination gives a clear picture of solid organ injury and free fluid. Most common injured viscera in the present study is small bowel and they were managed by simple suturing and closure of perforation and resection and anastomosis. Postoperative complications like wound infection, wound dehiscence, respiratory complications, pelvic abscess and faecal fistula were seen. The duration of stay for most of the patients in this study was between 11-20 days with mean of 15 days. Mortality in this study was 7%. Conditions such as, female gender, long interval between injury and operation, presence of shock on admission, and small bowel injury worsen the prognosis in penetrating abdominal trauma.Conclusions: Young males are most commonly affected due to road traffic accident. Conditions such as, female gender, long interval between injury and operation, presence of shock on admission, and small bowel injury worsen the prognosis in penetrating abdominal trauma.
23
Aljiffry, Murad M., and Mohammed Abdullah Bawazeer. "A comparative analysis of conservative management and laparotomy in cases of free air after blunt abdominal trauma: A comprehensive case series investigation." Saudi Surgical Journal 12, no. 2 (2024): 84–86. https://doi.org/10.4103/ssj.ssj_15_24.
Full textAbstract:
Abstract Blunt abdominal trauma resulting in injuries to hollow organs is uncommon, accounting for 1%–3% of cases. Diagnosing the condition remains challenging because of the absence of a standardized approach and the limitations of commonly used imaging techniques. We presented two cases of pneumoperitoneum resulting from blunt abdominal trauma. One was managed conservatively, and the other was managed with laparotomy. This article delves into the controversies surrounding the accuracy of computed tomography scans for hollow viscus injuries and advocates for a more nuanced diagnostic approach. The presence of free air alone should not prompt laparotomy, as demonstrated by our cases and supported by existing literature. We propose a cautious and conservative strategy in specific cases to minimize unnecessary laparotomies and their associated complications.
24
Jamal, Aska, Balen Muhammad, and Medya Sadeq. "A prospective evaluation of computerized tomography scan findings in blunt abdominal trauma." Zanco Journal of Medical Sciences 27, no. 1 (2023): 64–73. http://dx.doi.org/10.15218/zjms.2023.009.
Full textAbstract:
Background and objective: Evaluating patients with blunt abdominal trauma remains one of the most challenging aspects of acute trauma care. CT scan of abdomen remains the standard imaging modality for evaluation of abdominal trauma cases. The aim of this study is to evaluate CT scan findings in blunt abdominal trauma victims with respect to solid organ injuries, hollow viscus injuries, associated thoracic and abdominal wall injuries, associated hemoperitoneum, cause of injury and type of management. Methods: A cross-sectional study was conducted among 96 hemodynamically stable patients with history of blunt abdominal trauma who underwent CT scan examination in Rozh-halat Emergency Hospital from June 2021-January 2022; using a 64 multi-detector helical slice CT scanner. Data analysis were performed on patient’s demographics, mode and type of injury, CT scan findings and severity scorings, associated injuries and type of management. Results: The mean age of enrolled cases was 28.6 ± 18.6 ranged from 4-70 years. About two third (63.5%) were males and one third were females (36.5%). The most common cause of trauma was road traffic accident (64% of cases). Out of 96 trauma cases; 87.5% of patients had positive CT findings of which 50% had hemoperitoneum, 21.9% had pneumoperitoneum, 66.7% had no hallow viscous involvement, while 33.2% had hollow viscus involvement. One third of cases had associated abdominal wall injury. 56.4% of patients had multiple organ injury. Regarding solid organ injury; 66.7% of cases had spleen injury, (36.5%) had liver injury, Pancreas was involved in 12.5% of cases. RT& LT – kidneys showed grade 2 injury in (9.4%) & (6.3 %) respectively. Half of patients with positive CT scan findings had no lower chest injury findings. This study showed that 43.8% of cases were managed conservatively, 45.9% underwent laparotomy, the incidental finding of intra-operative hemoperitoneum which was negative in CT scan was only 1%. Conclusion: CT imaging is the diagnostic tool of choice for the evaluation of blunt abdominal trauma in haemo-dynamically stable patients as it can assist in detecting and evaluating other co-existing injuries such as lower thoracic, pelvic and spine injuries apart from its main role in accurate identification of intra -abdominal injuries and associated bleeding.
25
Schwed, Alexander C., David S. Plurad, Scott Bricker, et al. "Abdominal Hollow Viscus Injuries are Associated with Spine and Neurologic Infections after Penetrating Spinal Cord Injuries." American Surgeon 80, no. 10 (2014): 966–69. http://dx.doi.org/10.1177/000313481408001012.
Full textAbstract:
Penetrating spinal cord injuries are rare but potentially devastating injuries that are associated with significant morbidity. The objective of this study was to assess the impact of abdominal hollow viscus injuries (HVIs) on neurologic and spinal infectious complications in patients sustaining penetrating spinal cord injuries. We performed a 13-year retrospective review of a Level I trauma center database. Variables analyzed included demographics, injury patterns and severity, spine operations, and outcomes. Spine and neurologic infections (SNIs) were defined as para-spinal or spinal abscess, osteomyelitis, and meningitis. Multivariate analysis was performed to identify factors associated with SNI. Of 137 patients, there were 126 males (92%) with a mean age of 27 ± 10 years. Eight patients (6%) underwent operative stabilization of their spine. Fifteen patients (11%) developed SNI. There was a higher incidence of SNI among patients with abdominal HVI compared with those without (eight [26%] vs six [6%], P < 0.001). On multivariate analysis, after controlling for injury severity, solid abdominal injury and HVI, vascular injury, and spine operation, abdominal HVIs were independently associated with an increased risk for SNI (odds ratio, 6.88; 95% confidence interval, 2.14 to 22.09; P = 0.001). Further studies are required to determine the optimal management strategy to prevent and successfully treat these infections.
26
Reethika, Thatikonda1, Ramachandra Rao Komararagiri, Sashidhara Rao A., Bhandar Preerana, Punyapu Sridhar, and Sathyanarayana Gorthi. "Role of Diagnostic Laparoscopy in the Evaluation of Blunt Injury to Abdomen in Haemodynamically Stable Patients." International Journal of Current Pharmaceutical Review and Research 16, no. 01 (2024): 147–53. https://doi.org/10.5281/zenodo.11000899.
Full textAbstract:
AbstractPatients with blunt injury abdomen who are haemodynamically stable selective non-operative management hasshown good results. Diagnostic Laparoscopy is a minimally invasive procedure that allows rapid and thoroughinspection of whole abdominal cavity. Surgical intervention can also be done, if necessary, in the sameprocedure. This reduces the incidence of emergency laparotomies which decreases the mortality and morbidityof these patients.Aim and Objectives: To assess the role of Diagnostic Laparoscopy in the management of Blunt Injury toAbdomen in Hemodynamically stable patients. To assess the incidence of Hollow viscus Injury, Mesentericinjury and persistent bleeding not detected by clinical or radiological assessment.Material and Methods: 30 patietents of Blunt Trauma of Abdomen, who were haemodynamically stable andwere subjected to Diagnostic Laparoscopy were analazyed for clinically and radiologically missed injuries.Results: A total of 30 patients were studied. The Male to female ratio was 11:4 and the mean age was 33.46years. Common age group affected was 20-40 with a 59.94 % prevalence. Most common organ injured in blunttrauma to abdomen was Liver (79.92%). One case of Hollow viscus injury (3.33%) was discovered onDiagnostic Laparoscopy which could not be detected on CT scan. Two cases of Mesenteric tear (prevalence of6.66%) were detected, ongoing bleed was detected in three patients (prevalence of 9.99%) on diagnosticLaparoscopy. The liver injuries were managed laparoscopically. Diagnostic Laparoscopy to Open LaparotomyConversion was required only in 2 cases (6.66%). Therapeutic Laparoscopy was performed for 4 patients(13.32%).Wound infection was the only complication seen in two patients, (6.66%) and there were no missedorgan injuries post diagnostic laparoscopy.Conclusion: Diagnostic Laparoscopy can be a recommended modality in the diagnosis and management ofhaemodynamically stable patients with blunt trauma to abdomen
27
Maharjan, Prabir, Shiv Vansh Bharti, Digbijay Bikram Khadka, Anup Karki, and Arun Gnyawali. "Isolated perforation of fourth part of Duodenum following Blunt Abdominal Trauma." Journal of Nepalgunj Medical College 19, no. 1 (2022): 106–8. http://dx.doi.org/10.3126/jngmc.v19i1.40442.
Full textAbstract:
Introduction: Isolated duodenal injuries are rare in blunt abdominal trauma. These present a significant challenge for management because of the associated injuries and its difficult anatomical accessibility.
 Case presentation: A 20years male presented to the Emergency department following a bike accident sustaining injury over face, chest and abdomen, 6hours after the incident. His vitals were unstable so he was resuscitated and admitted in Intensive Care Unit. He had generalized abdominal tenderness without rigidity. Contrast enhanced computed tomography of abdomen and pelvis was suggestive of hollow viscus perforation. He underwent exploratory laparotomy and primary repair for isolated perforation at fourth part of duodenum. He was discharged on his ninth postoperative day.
 Conclusion: Rare injuries following blunt abdominal trauma should be considered and early intervention is necessary.
28
Al-Sindy, Ruj, Heleen Alaqrawy, Mahmood Sh Hafdullah, and Christine Butts. "Identification of Hollow Viscus Injury with FAST Examination in Kurdistan, Iraq." Case Reports in Emergency Medicine 2018 (2018): 1–4. http://dx.doi.org/10.1155/2018/5019415.
Full textAbstract:
Point-of-care ultrasound has become indispensable in the evaluation of trauma, particularly in low resource areas, where it may be the only rapidly available imaging modality. The FAST (Focused Assessment with Sonography in Trauma) in particular can be lifesaving, by rapidly detecting signs of intra-abdominal hemorrhage. However, the FAST is primarily designed to identify free fluid associated with solid organ injury and is thought to have less sensitivity and power in identifying evidence of hollow viscus injury. We present a case of an unidentified man that presented to a hospital in the Kurdistan region of northern Iraq, a region of low resources, surrounded by war. The FAST exam proved to be the key to identifying this patient’s injuries.
29
Otsuka, Hiroyuki, Tomokazu Fukushima, Youhei Tsubouchi, Keiji Sakurai, and Sadaki Inokuchi. "Current strategy for hollow viscus injury with active bleeding: A case report." SAGE Open Medical Case Reports 7 (January 2019): 2050313X1882481. http://dx.doi.org/10.1177/2050313x18824816.
Full textAbstract:
Despite rapid advancements in medical technologies, the use of interventional radiology in a patient with hemodynamic instability or hollow viscus injury remains controversial. Here, we discuss important aspects regarding the use of interventional radiology for such patients. A 74-year-old Japanese male climber was injured following a 10 m fall. On admission, his systolic blood pressure was 40 mmHg. He had disturbance of consciousness and mild upper abdominal pain without peritoneal irritation. Focused assessment sonography for trauma indicated massive hemorrhage in the intra-abdominal cavity. Plain radiographs revealed hemopneumothorax with right-side rib fractures. Thoracostomy to the right thoracic cavity and massive transfusion were immediately performed. Consequently, a sheath catheter was inserted into the common femoral artery for interventional radiology. His systolic blood pressure increased to 80 mmHg owing to rapid transfusion. In the computed tomography scan room, based on computed tomography findings, we judged that it was possible to achieve hemostasis by interventional radiology. The time from hospital admission to entering the angiography suite was 38 min. Transcatheter arterial embolization for hemorrhage control was performed without complications. Following transcatheter arterial embolization, he was admitted to the intensive care unit. All injuries could be treated conservatively without surgery. His post-interventional course was uneventful, and he recovered completely after rehabilitation. Hemorrhage control using interventional radiology should be assessed as a first-line treatment, even in hemodynamically unstable patients having a hollow viscus injury with active bleeding, without obvious findings that indicate surgical repair.
30
Yanar, H., B. Ozcinar, K. Taviloglu, C. Ertekin, R. Guloglu, and E. Arabaci. "Selective Conservative Management of Penetrating Hollow Viscus Injuries: a Report of Three Cases." Acta Chirurgica Belgica 110, no. 4 (2010): 479–83. http://dx.doi.org/10.1080/00015458.2010.11680660.
Full text
31
Yamamoto, Ryo, Mark Muir, and Alicia Logue. "Colon Trauma: Evidence-Based Practices." Clinics in Colon and Rectal Surgery 31, no. 01 (2017): 011–16. http://dx.doi.org/10.1055/s-0037-1602175.
Full textAbstract:
AbstractColon injury is not uncommon and occurs in about a half of patients with penetrating hollow viscus injuries. Despite major advances in the operative management of penetrating colon wounds, there remains discussion regarding the appropriate treatment of destructive colon injuries, with a significant amount of scientific evidence supporting segmental resection with primary anastomosis in most patients without comorbidities or large transfusion requirement. Although literature is sparse concerning the management of blunt colon injuries, some studies have shown operative decision based on an algorithm originally defined for penetrating wounds should be considered in blunt colon injuries. The optimal management of colonic injuries in patients requiring damage control surgery (DCS) also remains controversial. Studies have recently reported that there is no increased risk compared with patients treated without DCS if fascial closure is completed on the first reoperation, or that a management algorithm for penetrating colon wounds is probably efficacious for colon injuries in the setting of DCS as well.
32
Srivastava, Sandesh Kumar, Anand Kumar Jaiswal, and Dinesh Kumar. "Prospective study of management and outcome of blunt abdominal trauma (solid organs and hollow viscus injuries)." International Surgery Journal 4, no. 10 (2017): 3262. http://dx.doi.org/10.18203/2349-2902.isj20174143.
Full textAbstract:
Background: Blunt abdominal trauma is a leading cause of morbidity and mortality among all age groups. Many injuries may not manifest during the initial assessment and treatment period. Injury to intra-abdominal structures can be classified into 2 primary mechanism of injury-compression forces and deceleration forces. Compression or concussive force may result from direct blows or external compression against a fixed object. Deceleration forces causes stretching and linear shearing between relatively fixed and free objects.Methods: A prospective study of 48 patients admitted with blunt abdominal injuries in the department of surgery, B.R.D. Medical College Gorakhpur during a period of 1 year.Results: Majority of patients of blunt abdominal injuries in present study were in 11-20 year of age group followed by 31-40 year of age group followed by 41-50 year of age group. Female to male ratio was 7:1. In the present study 41% of patients were subjected to non-operative management.Conclusions: Males were pre-dominantly affected. Road traffic accident was the most common cause of injury. Though conservative management is successful in carefully selected patients, operative management remains the main stay of treatment.
33
Li, Yong-Gang, Zhi-Yong Wang, Ji-Guang Tian, Yu-Hang Su, and Xi-Guang Sang. "Iliac ecchymosis, a valuable sign for hollow viscus injuries in blunt pelvic trauma patients." Chinese Journal of Traumatology 24, no. 3 (2021): 136–39. http://dx.doi.org/10.1016/j.cjtee.2021.03.002.
Full text
34
Fabian, Timothy C. "Infection in Penetrating Abdominal Trauma: Risk Factors and Preventive Antibiotics." American Surgeon 68, no. 1 (2002): 29–35. http://dx.doi.org/10.1177/000313480206800107.
Full textAbstract:
Infection remains the greatest risk for victims of penetrating abdominal injury with major infections occurring in 10 to 15 per cent. Attributable mortality is approximately 30 per cent of those who develop major abdominal infections. In addition to this morbidity infection adds approximately $43,000.00 of hospital charges per infected patients. This article addresses two significant areas: risk factors and antibiotic utilization. The most important risk factor is the presence of hollow viscus injury; colonic wounding carries the highest incidence of infection relative to intra-abdominal organs injured. Pancreatic and liver injuries significantly increase infection risk when combined with hollow viscus wounds. The degree of injury as measured by the volume of hemorrhage and the presence of shock as well as the anatomic degree of injury likewise correlates with the incidence of septic morbidity. Antibiotic utilization is addressed by the three issues of antibiotic agents of choice, duration of administration, and optimal dosing. Regimens of choice should include anaerobic coverage. Twenty-four hours of antibiotic administration is satisfactory with currently available agents. Evidence-based medicine analyses from the Eastern Association for the Surgery of Trauma have addressed those two issues. There are few data on optimal dosing. Increased volumes of distribution and rates of excretion have been demonstrated in trauma patients. This would suggest that higher-than-normal doses should be used. Laboratory studies would support such an approach. However, significant clinical research is desirable to address issues of concentration-dependent bacterial killing and time-dependent killing. Those pharmo-dynamic considerations are variable among antibiotic classes.
35
Tyroch, Alan H., Emmett L. Mcguire, Susan F. Mclean, et al. "The Association between Chance Fractures and Intra-abdominal Injuries Revisited: A Multicenter Review." American Surgeon 71, no. 5 (2005): 434–38. http://dx.doi.org/10.1177/000313480507100514.
Full textAbstract:
The association between Chance fractures and intra-abdominal injuries is reported to be as high as 89 per cent. Because prior studies were small series or case reports, we conducted a multicenter review to learn the true association between Chance fractures and intra-abdominal injuries as well as diagnostic trends. Trauma registry data, medical records, and radiology reports from 7 trauma centers were used to characterize 79 trauma patients with Chance fractures. Initial methods of abdominal assessment were computed tomography (CT) scan (79%), clinical examination (16%), and diagnostic peritoneal lavage (DPL) (5%). Twenty-six (33%) patients had intraabdominal injuries of which hollow viscus injuries predominated (22%). Twenty patients (25%) underwent laparotomy. The presence of an abdominal wall contusion and automobile restraint use were highly predictive of intra-abdominal injury and the need for laparotomy. The association between a Chance fracture and intra-abdominal injury is not as high as previously reported. CT scan has become the primary modality to assess the abdominal cavity of patients with Chance fractures, whereas the role of DPL has diminished.
36
Kim, Hyung Won, Bo Ram Park, and Tae Hwa Hong. "Application of Computed Tomography in the Identification of Hollow Viscus Injuries in Blunt Trauma Patients." Journal of Acute Care Surgery 12, no. 1 (2022): 29–33. http://dx.doi.org/10.17479/jacs.2022.12.1.29.
Full textAbstract:
Purpose: Despite advances in diagnostic and imaging technologies, the diagnosis of traumatic hollow viscus injury (HVI) remains a great challenge in clinical practice. This study aimed to determine the accuracy of computed tomography (CT) in the diagnosis of HVI in emergent blunt trauma patients.Methods: The study was conducted on patients with abdominal trauma who were admitted to our center, regional emergency center, Kyung Hee University Medical Center, between January 2008 and December 2018. The clinical data of patients with abdominal trauma who underwent CT and abdominal surgery within 24 hours of hospitalization were analyzed to determine the diagnostic capacity of CT.Results: In total, 156 patients were included in the study. There were 88 cases of blunt trauma. Among these patients, 27 were diagnosed with HVI using CT, and 38 patients were diagnosed with HVI in the operating room. The median injury severity score for these patients was 10.0, the revised trauma score was 7.841, and the trauma injury severity score was 0.96. The sensitivity and specificity of CT in predicting HVI in these patients were 65.8%, and 96.0%, respectively. The positive and negative predictive values were 92.6%, and 78.7%, respectively.Conclusion: In urgent situations, CT findings alone are insufficient for diagnosing HVI. Further research on the HVI diagnostic capacity of CT is required.
37
Blum, Craig A., Craig Selander, Jean Marie Ruddy, and Stuart Leon. "The Incidence and Clinical Significance of Pneumoperitoneum after Percutaneous Endoscopic Gastrostomy: A Review of 722 Cases." American Surgeon 75, no. 1 (2009): 39–43. http://dx.doi.org/10.1177/000313480907500108.
Full textAbstract:
Percutaneous endoscopic gastrostomy (PEG) is the procedure of choice for establishing enteral access in patients unable to take oral feedings. Serious complications are rare; however, misplaced PEGs and PEG/ Jejunums can lead to hollow viscus injuries with intra-abdominal contamination and subsequent peritonitis, septicemia, and death. The presence of free intra-abdominal air is a reliable indicator of a perforated viscus and often points to a surgical emergency; however, in the case of PEGs, pneumoperitoneum without a perforated viscus, or “benign pneumoperitoneum” creates a diagnostic dilemma. To determine the incidence and clinical significance of pneumoperitoneum after PEG or PEG/Jejunum (J) we reviewed the records of 722 patients who underwent these procedures at our institution. Of 39 patients found to have free air after PEG/PEG/J placement, 33 (85%) had “benign pneumoperitoneum” and were discharged without complication or surgical intervention. Of the six patients with serious complications related to their procedure, five (83%) had clinical signs of intra-abdominal complications (peritonitis) that helped guide their management. Of these six patients, the two receiving abdominal radiographs instead of abdominal CT scanning had a 50 per cent negative laparotomy rate. We present an algorithm for the management of patients found to have pneumoperitoneum after PEG or PEG/J placement.
38
Swaid, Forat, Kobi Peleg, Ricardo Alfici, et al. "Concomitant hollow viscus injuries in patients with blunt hepatic and splenic injuries: An analysis of a National Trauma Registry database." Injury 45, no. 9 (2014): 1409–12. http://dx.doi.org/10.1016/j.injury.2014.02.027.
Full text
39
Skelhorne-Gross, Graham, Jordan Nantais, Noah Ditkofsky, and David Gomez. "Massive traumatic abdominal wall hernia with significant tissue loss: challenges in management." BMJ Case Reports 14, no. 5 (2021): e242609. http://dx.doi.org/10.1136/bcr-2021-242609.
Full textAbstract:
A 41-year-old woman presented to our trauma centre following a high-speed motor vehicle collision with a seatbelt pattern of injury resulting in extensive rupture of her abdominal wall musculature and associated hollow viscus injuries. The abdominal wall had vertical separation between transected rectus, bilateral transverse abdominis and oblique muscles allowing evisceration of small and large bowel into the flanks without skin rupture. Intraoperatively, extensive liquefaction and tissue loss of the abdominal wall was found with significant retraction of the remaining musculature. Initial operative management focused on repair of concomitant intra-abdominal injuries with definitive repair performed in delayed, preplanned stages including bridging with absorbable mesh and placement of an overlying split-thickness skin graft. The patient was discharged from hospital and underwent extensive rehabilitation. One year later, the abdominal wall was definitively repaired with components separation and biological mesh underlay. This stepwise repair process provided her with a robust and enduring abdominal wall reconstruction.
40
Tan, Ker-Kan, Jody Zhiyang Liu, Tsung-Shyen Go, Appasamy Vijayan, and Ming-Terk Chiu. "Computed tomography has an important role in hollow viscus and mesenteric injuries after blunt abdominal trauma." Injury 41, no. 5 (2010): 475–78. http://dx.doi.org/10.1016/j.injury.2009.09.028.
Full text
41
Lin, Heng-Fu, Ying-Da Chen, Keng-Li Lin, Meng Che Wu, Cheng Yi Wu, and Shyr-Chyr Chen. "Laparoscopy decreases the laparotomy rate for hemodynamically stable patients with blunt hollow viscus and mesenteric injuries." American Journal of Surgery 210, no. 2 (2015): 326–33. http://dx.doi.org/10.1016/j.amjsurg.2014.11.009.
Full text
42
Wassem Ameer Shater, Mohammad Ali Nasser, Ali Mohammad Allou, Wassem Ameer Shater, Mohammad Ali Nasser, Ali Mohammad Allou. "Management of pediatric blunt abdominal trauma: تدبير رضوح البطن الكليلة عند الأطفال". Journal of medical and pharmaceutical sciences 5, № 4 (2021): 27–20. http://dx.doi.org/10.26389/ajsrp.s050821.
Full textAbstract:
Aim of study: Evaluating a non- operative treatment of pediatric blunt abdominal trauma and avoiding unnecessary surgical intervention in Tishreen University Hospital. Methods: During years (2016- 2020) a retroprospective study was conducted on 62 children who had isolated blunt abdominal trauma or associated with other injuries, most of them were managed by non- operative treatment but some required surgical management. Results: Non- operative management of pediatric blunt abdominal injuries was applied for 59 patients, three patients required a surgical procedure, the spleen was the most organ exposed to injury (40) child, followed by liver (26) child, kidney (4) and (1) pancreatic injury. Non- operative management was successful in most solid organs injuries with grades 1, 2 and 3, but it failed in 5 grade splenic injury. one out of two hollow viscus injuries required surgical intervention. There were no statistical differences between the study groups in age, gender and injury mechanism. Hospital length of stay was significantly longer in patients who underwent a laparotomy (6) days compared to other non- operative patients (3) days, one complication occurred during non- operative management as pseudocyst after pancreatic injury, (4) patient died in the non- operative group due to hemodynamic instability and associated severe cerebral injuries. Conclusion: It is safe to treat most children with blunt abdominal injuries non- operatively if monitoring is adequate with hemodynamic stability.
43
Salim, Ali, Marcus Ottochian, Ryan J. Gertz, et al. "Intraabdominal Injury is Common in Blunt Trauma Patients who Sustain Spinal Cord Injury." American Surgeon 73, no. 10 (2007): 1035–38. http://dx.doi.org/10.1177/000313480707301025.
Full textAbstract:
The evaluation of the abdomen in patients with spinal cord injury (SCI) is challenging for obvious reasons. There are very little data on the incidence and complications of patients who sustain SCI with concomitant intraabdominal injury (IAI). To determine the incidence and outcomes of IAI in blunt trauma patients with SCI, a trauma registry and record review was performed between January 1998 and December 2005. Baseline demographic data, Injury Severity Score, and associated IAI were collected. Two groups were established and outcomes were analyzed based on the presence or absence of IAI. Intraabdominal and hollow viscus injures were found in 15 per cent and 6 per cent, respectively, of 292 patients with blunt SCI. The presence of intraabdominal injury varied according to the level of the SCI: 10 per cent of cervical, 23 per cent of thoracic, and 18 per cent of lumbar SCI. The overall mortality was 16 per cent. The presence of intraabdominal injury was associated with longer intensive care unit length of stay (13 versus 6 days, P < 0.01), hospital length of stay (23 versus 18 days, P < 0.05), higher complication rate (46% versus 33%, P = 0.09), and higher mortality (44% versus 11%, P < 0.01) when compared with patients with SCI without IAI. Intraabdominal injuries are common in blunt SCI. Liberal evaluation with computed tomography is necessary to identify injuries early.
44
Soon, David SC, Yit J. Leang, and Charles HC Pilgrim. "Operative versus non-operative management of blunt pancreatic trauma: A systematic review." Trauma 21, no. 4 (2018): 252–58. http://dx.doi.org/10.1177/1460408618788111.
Full textAbstract:
Introduction Motor vehicle crashes are common causes of blunt abdominal trauma in the 21st century. While splenic trauma occurs very frequently and thus there is a well-established treatment paradigm, traumatic pancreatic injuries are relatively infrequent, occurring in only 3–5% of traumas. This low incidence means physicians have reduced experience with this condition and there is still ongoing debate with regards to the best practice in managing pancreatic trauma. During severe trauma, the pancreas can be injured as a consequence of blunt and penetrating injury. This has an estimated mortality rate ranging from 9 to 34%. Methods A systematic review was performed using three scientific databases: Embase, Medline and Cochrane and in-line with the PRISMA statement. We included only articles published in English, available as full text and describing only adults. Keywords included: pancrea*, trauma, blunt, operative management and non-operative management. Results Three studies were found that directly compared operative versus non-operative management in blunt pancreatic trauma. Length of stay, mortality and rate of re-intervention were lower in the non-operative group compared to the operative group. However, the average grade of pancreatic injury was lower in the non-operative group compared to the operative group. Discussion Our results revealed that patients who undergo non-operative management tend to have lower grade of injuries and patients with higher grade of injury tend to be managed in an operative fashion. This could be likely due to the fact that higher grade of pancreatic injuries is often accompanied by other injuries such as hollow viscus injury and therefore require operative intervention. Conclusion Non-operative management is a safe approach for low-grade blunt pancreatic trauma without ductal injuries. However, more evidence is required to improve our understanding and treatment plans. We suggest a large international multicentre study combining data from multiple international trauma centres to collect adequate data.
45
Bansal, Lalit Kumar, Raja Bhanukiran, Poras Chaudhary, and Arun Kumar Gupta. "Penetrating trans-abdominal bamboo stick injury: An unusual case report." Journal of Emergency Practice and Trauma 7, no. 2 (2021): 137–39. http://dx.doi.org/10.34172/jept.2021.04.
Full textAbstract:
Objective: Penetrating abdominal trauma secondary to bamboo stick injury is a rare entity in the developed world. Most of such kind of trans abdominal penetrating bamboo stick injury is associated with multiple solid and hollow viscus injuries. In developing countries like India, where nearly 70% of the population reside in rural areas, it is not that uncommon. Aim of this report is to recognition of risk factors and explain optimum surgical management in trans-abdominal bamboo stick injury. Case Presentation: Here we describe a case of penetrating trans abdominal bamboo stick injury resulting due to fall over a branch of bamboo stick with multiorgan damage, which was successfully managed by early surgical exploration in our institute. Conclusion: There are many factors which can prognosticate the penetrating trauma cases. The most important factors include a long interval between injury and surgical exploration, presence or absence of shock, and other associated organ injuries at the time of admission. Early recognition of the severity of injury with surgical management is utmost necessary. These patients have high morbidity and mortality rates due to multiorgan damage and post-operative infection.
46
Cinquantini, Francesco, Gregorio Tugnoli, Alice Piccinini, et al. "Educational Review of Predictive Value and Findings of Computed Tomography Scan in Diagnosing Bowel and Mesenteric Injuries after Blunt Trauma: Correlation with Trauma Surgery Findings in 163 Patients." Canadian Association of Radiologists Journal 68, no. 3 (2017): 276–85. http://dx.doi.org/10.1016/j.carj.2016.07.003.
Full textAbstract:
Background and Aims Laparotomy can detect bowel and mesenteric injuries in 1.2%–5% of patients following blunt abdominal trauma. Delayed diagnosis in such cases is strongly related to increased risk of ongoing sepsis, with subsequent higher morbidity and mortality. Computed tomography (CT) scanning is the gold standard in the evaluation of blunt abdominal trauma, being accurate in the diagnosis of bowel and mesenteric injuries in case of hemodynamically stable trauma patients. Aims of the present study are to 1) review the correlation between CT signs and intraoperative findings in case of bowel and mesenteric injuries following blunt abdominal trauma, analysing the correlation between radiological features and intraoperative findings from our experience on 25 trauma patients with small bowel and mesenteric injuries (SBMI); 2) identify the diagnostic specificity of those signs found at CT with practical considerations on the following clinical management; and 3) distinguish the bowel and mesenteric injuries requiring immediate surgical intervention from those amenable to initial nonoperative management. Materials and Methods Between January 1, 2008, and May 31, 2010, 163 patients required laparotomy following blunt abdominal trauma. Among them, 25 patients presented bowel or mesenteric injuries. Data were analysed retrospectively, correlating operative surgical reports with the preoperative CT findings. Results We are presenting a pictorial review of significant and frequent findings of bowel and mesenteric lesions at CT scan, confirmed intraoperatively at laparotomy. Moreover, the predictive value of CT scan for SBMI is assessed. Conclusions Multidetector CT scan is the gold standard in the assessment of intra-abdominal blunt abdominal trauma for not only parenchymal organs injuries but also detecting SBMI; in the presence of specific signs it provides an accurate assessment of hollow viscus injuries, helping the trauma surgeons to choose the correct initial clinical management.
47
Skube, Mariya E., Quinn Mallery, Elizabeth Lusczek, Joel Elterman, Mary A. Spott, and Greg J. Beilman. "Characteristics of Combat-Associated Small Bowel Injuries." Military Medicine 183, no. 9-10 (2018): e454-e459. http://dx.doi.org/10.1093/milmed/usy009.
Full textAbstract:
AbstractIntroductionAlthough there are multiple studies regarding the management and outcomes of colonic injuries incurred in combat, the literature is limited with regard to small bowel injuries. This study seeks to provide the largest reported review of the characteristics of combat-associated small bowel injuries.Materials and MethodsThe Department of Defense Trauma Registry was queried for U.S. Armed Forces members who sustained hollow viscus injuries in the years 2007–2012 during Operations Enduring Freedom, Iraqi Freedom, and New Dawn. Concomitant injuries, procedures, and complications were delineated. Fisher’s exact test was used to analyze the relationship of bowel injury pattern to rates of repeat laparotomy, fecal diversion, and complications.ResultsOne hundred seventy-one service members had small bowel injuries. The mean age was 25.8 ± 6.6 yr with a mean injury severity score of 27.9 ± 12.4. The majority of injuries were penetrating (94.2%, n = 161) as a result of explosive devices (61.4%, n = 105). The median blood transfusion requirement in the first 24 h was 6.0 units (interquartile range 1.0–17.3 units). The most frequent concomitant injuries were large bowel (64.3%, n = 110), pelvic fracture (35.7%, n = 61), and perineal (26.3%, n = 45). Fifty patients (29.2%) had a colostomy, and nine patients (5.3%) had an ileostomy; 62.6% (n = 107) of soldiers underwent more than one laparotomy. The mortality rate was 1.8% (n = 3). The most common complications were pneumonia (15.2%, n = 26), deep vein thrombosis (14.6%, n = 25), and wound infection (14.6%, n = 25). The need for repeat laparotomy and fecal diversion was found to be significantly associated with injury pattern (p = 0.00052 and p < 0.0001, respectively).ConclusionWe found that two-thirds of service members with small bowel injuries also had a large bowel injury. One-third of the patients required diversion and two-thirds had more than one laparotomy. The pattern of bowel injury significantly affected the need for repeat laparotomy and fecal diversion.
48
Roshini, A. P., Audi Pandarinath, and Mervyn Correia. "Bucket handle injury of small bowel: a case report." International Surgery Journal 10, no. 4 (2023): 773–75. http://dx.doi.org/10.18203/2349-2902.isj20230995.
Full textAbstract:
Hollow viscus or mesenteric injuries account for 1-6% of injuries in a patient with blunt abdominal trauma. A 63-year-old male, presented with a history of tree fall while he was on a two-wheeler. With a history of left hip pain and abdominal pain, examination revealed he was tachycardic, normotensive with abrasions and dislocation of left hip joint. Abdomen examination revealed diffuse tenderness with sluggish bowel sounds with blood at the meatus. FAST was positive. CECT showed mesenteric hematoma, intra-peritoneal rupture of bladder and multiple pelvic fractures. Laparotomy revealed a rent in the anterior wall and neck of urinary bladder, which was repaired along with a bucket handle tear of mesentery, 40 cm from ICJ, with gangrene of ileum which required resection anastomosis. Post-operative period was uneventful. Rapid deceleration in a road traffic accident causes shearing forces between segments of bowel fixed in the retroperitoneum and the more mobile peritoneal segments, which leads to avulsion of mesentery from the bowel known as bucket handle injury. These are traumatic ischemic injury, which require urgent surgical intervention. Due to the varying CT findings, a pre-operative diagnosis is very challenging and required high index of suspicion. Prompt diagnosis and surgical management is required to prevent delayed complications in bucket handle injuries of bowel.
49
Teixeira, Pedro G. R., Kenji Inaba, Joseph Dubose, et al. "Enterocutaneous Fistula Complicating Trauma Laparotomy: A Major Resource Burden." American Surgeon 75, no. 1 (2009): 30–32. http://dx.doi.org/10.1177/000313480907500106.
Full textAbstract:
Enterocutaneous fistula (ECF) is an uncommon and poorly studied postoperative complication. The objective of this study was to analyze the incidence and resource utilization of patients who developed an ECF after trauma laparotomy. All patients with an ECF occurring after trauma laparotomy at a Level I trauma center were identified through a review of both the Trauma Registry and the Morbidity and Mortality reports for a 9-year period ending in December 2006. Each ECF case was matched with a control (non-ECF) that did not develop this complication after laparotomy. The matching criteria were: age, gender, mechanism of injury, Injury Severity Score, Abbreviated Injury Score, and damage control laparotomy requiring an open abdomen. Outcomes analyzed were intensive care unit (ICU) and hospital length of stay, mortality, and total hospital charges. During the 9-year period, of 2373 acute trauma laparotomies performed, 36 (1.5%) patients developed an enterocutaneous fistula, and were matched to 36 controls. Patients with an ECF were 31 ± 12 years of age, were 97 per cent male, had a mean Injury Severity Score of 21 ± 10, and 75 per cent were penetrating. Eighty-nine per cent of the ECF patients had a hollow viscus injury. The most common was colon (69%), followed by small bowel (53%), duodenum (36%), and stomach (19%). Fifty-six per cent of the ECF patients had multiple hollow viscus injuries. The development of an ECF was associated with significantly increased ICU length of stay (28.5 ± 30.5 vs 7.6 ± 9.3 days, P = 0.004), hospital length of stay (82.1 ± 100.8 vs 16.2 ± 17.3 days, P < 0.001), and hospital charges ($539,309 vs $126,996, P < 0.001). In conclusion, the development of an enterocutaneous fistula after laparotomy for trauma resulted in a significant impact on resource utilization including longer ICU and hospital length of stay and higher hospital charges. Further investigation into the prevention and treatment of this costly complication is warranted.
50
Sarker, MM, MK Sarker, and NA Perveen. "Intra- Abdominal Injuries Following Blunt Abdominal Trauma-Analysis of 100 cases." TAJ: Journal of Teachers Association 28, no. 2 (2018): 7–14. http://dx.doi.org/10.3329/taj.v28i2.39073.
Full textAbstract:
With the advent of industrialization, accelerated social violence, increasing road traffic accident and increasing use of machineries trauma has become the leading cause of mortality and disability. Considering trauma abdominal trauma is one where early diagnosis and accurate assessment and timely intervention can save the life of the victim in most of the instances. This is a prospective observational study that represents the experience of 100 consecutive patients of blunt abdominal trauma with suspected intra-abdominal injuries admitted in surgical words of RMCH, Rajshahi. The most of the patients were male (87%) and in active phase of life. RTA (53%) was the most common cause of blunt abdominal trauma and majority of the patients (38%) arrived in the hospital within 7-24 hours. Major clinical signs of intra-abdominal injuries were signs of peritonitis. The main investigation done was plain X-ray abdomen (71%) in erect posture, of which 55% cases showed free gas under the done of the diaphragm. Out of 100 cases 77 patients were operated upon and 23 patients were managed conservatively. The incidence of hollow viscus injury (57%) was higher than solid organs (36%) injury but only five patients came out to be a negative laparotomy. Of all operated cases fifty one were recovered uneventfully and only twenty three patients developed various postoperative complications. The most of the patients (40%) left the hospital within 11-14 days. Seven patients died on the day of admission but total mortality was nine (9%) in number.TAJ 2015; 28(2): 7-14