Approach and Management of Traumatic Retroperitoneal Injuries

Petrone, Patrizio; Álvarez, Cristina Magadán; Joseph, D’Andrea; Cartagena, Lee; F, Ali; Brathwaite, Collin

doi:10.1016/j.cireng.2018.02.014

Cited by 2 publications

(2 citation statements)

References 115 publications

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“…Subsequently, a right medial visceral rotation (Cattell-Braasch maneuver) can be performed to examine the inferior vena cava, infrarenal aorta, third portion of the duodenum, and head of the pancreas. The lesser sac could be opened to inspect the body and tail of the pancreas [8,9]. For our patient, we had to check not only intraperitoneal but also retroperitoneal spaces.…”

Section: Discussionmentioning

confidence: 99%

Combined stomach and duodenal perforating injury following blunt abdominal trauma: a case report and literature review

2020

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Background Gastrointestinal injury following blunt abdominal trauma is uncommon; a combined stomach and duodenal perforating injury is even more rare. Because these two organs are located in different spaces in the abdomen, such injuries are difficult to identify. Case presentation A young woman involved in a motor vehicle crash presented to our emergency department with concerns of severe peritonitis. Contrast-enhanced computed tomography of the abdomen revealed pneumoperitoneum and retroperitoneal hematoma in zone 1. An emergency laparotomy was performed, revealing a stomach-perforating injury, which was resolved with primary repair. No obvious injury was observed on retroperitoneal exploration. However, peritonitis presented again on the second postoperative day, and a second laparotomy was performed, revealing a duodenum-perforating injury in its third portion. We performed primary repair with multi-tube-ostomy. The patient recovered well without permanent tube placement or internal bypass. Conclusions Assessing associated injuries in blunt abdominal trauma is crucial because they may be fatal if timely intervention is not undertaken. These types of complicated injuries require a feasible surgical strategy formulated by experienced surgeons, which gives the patient a better chance of survival.

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Section: Discussionmentioning

confidence: 99%

Combined stomach and duodenal perforating injury following blunt abdominal trauma: a case report and literature review

2020

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“…Exploration will be done for an expanding hematoma or one that has failed the alternative methods of hemorrhage control like angioembolization or for the presence of associated injuries or when there is suspicion of ureteral injuries. Do not explore a contained, non-expanding hematoma [9]. Zone 3 -Do not explore and utilize a method for hemorrhage control, such as intraoperative preperitoneal packing or angioembolization.…”

Section: For Blunt Injurymentioning

confidence: 99%

Blunt Abdominal Injury

Mehanathan¹,

Metha²,

Jeyapaul³

et al. 2022

Trauma and Emergency Surgery

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Road traffic accidents are one of the leading causes of mortality. Blunt injury abdomen contributes to the mortality in road traffic accidents second to head injury. The mechanism of injury in road traffic accidents are due to blunt force created by collision between the patient and the external forces, acceleration and deceleration forces acting on the person’s internal forces. The common solid organs involved in blunt abdominal trauma are Spleen, Liver, and Kidney. Mesenteric tear and isolated small bowel injuries can also occur. Blunt abdominal trauma is one of the very common emergencies in the emergency department. High degree of suspicion and watchfulness, regular examination, imaging and investigations are needed to diagnose blunt injury abdomen. E-FAST is the emergency screening tool used to diagnose intra-abdominal injuries in emergency department even in hemodynamically unstable patient. The treatment will depend on the hemodynamical status, whether stable or unstable. Hemodynamically unstable patient with positive E-FAST will be taken up for emergency exploration while stable patient will undergo further imaging and investigation to plan the management. The chapter will discuss about the grades of injuries in spleen, Liver, mesentery and retroperitoneum. It will also discuss about the various diagnostic and treatment modalities available and when and where to use them to improve the quality of management. This chapter will be useful for the surgical postgraduates and young budding surgeons and trauma surgeons.

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Approach and Management of Traumatic Retroperitoneal Injuries

Cited by 2 publications

References 115 publications

Combined stomach and duodenal perforating injury following blunt abdominal trauma: a case report and literature review

Combined stomach and duodenal perforating injury following blunt abdominal trauma: a case report and literature review

Blunt Abdominal Injury

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