Blunt abdominal injury: A review of 59 consecutive cases undergoing surgery

Abstract

1. A consecutive series of 59 patients undergoing laparotomy as a result of blunt abdominal trauma is reported. 2. Road‐traffic accidents were the most common cause of blunt abdominal trauma and frequently produced a complex pattern of associated injuries. 3. There were 8 deaths, giving a mortality‐rate of 14 per cent. 4. The number of associated injuries was the most important single factor influencing the mortality‐rate. 5. Delay in diagnosis occurred in 14 patients, and this may contribute to the high mortality‐rate of blunt abdominal injury. 6. A high index of suspicion, thorough and repeated clinical assessment, and willingness to resort to laparotomy are the main principles in the diagnosis of blunt abdominal injury.

Hepatic resection for trauma, tumour and biliary obstruction

“…In this series abdominal paracentesis was not employed and peritoneal lavage only rarely. Emphasis was placed on careful observation and repeated examination, laparotomy being performed on suspicion (Bolton et al, 1973).…”

Selective Vascular Occlusion With Staged Hemihepatectomy for Blunt Liver Trauma

“…The authors did not use this approach because they considered that the risks associated with resection in the face of a severe coagulopathy would have been prohibitive. 17,18 We acknowledge that the place of the selective Pringle manoeuvre will be limited because of the relative rarity of the circumstances that were found in the present case. Nevertheless, we believe that it adds an extra useful technique to the surgeon in dealing with massive liver trauma.…”

“…The authors did not use this approach because they considered that the risks associated with resection in the face of a severe coagulopathy would have been prohibitive. 17,18 …”

Homicidal blunt abdominal trauma with isolated laceration of the small bowel mesentery

“…Because of the difficulty in establishing the diagnosis of contusions and lacerations of the superior mesenteric vessels, its true incidence is not known. Obviously, however, such lesions are indeed rare (MacLeod and Nicholson 1969;Bolton et al 1973;McCullough 1976;Myers 1976).…”