Diagnosis of Acute Abdominal Injuries in Patients with Spinal Shock

Pa, Tibbs; Ab, Young; Ba, Bivins; Cr, Sachatello

doi:10.1097/00005373-198001000-00008

Cited by 11 publications

(6 citation statements)

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“…Mechanisms such as motor vehicle collisions and pedestrian-struck accidents; associated injuries such as lower rib fractures, pelvic fractures, and thoracic injuries; hypotension on admission; and abdominal wall contusions, i.e., seatbelt signs, have all been identified as risk factors for significant IAI. 4,10,12,13 We did not identify any risk factors for injury. It seems intuitive, however, a mechanism significant enough to cause a SCI should be significant enough to cause other associated injuries.…”

Section: Discussionmentioning

confidence: 96%

“…[1][2][3][4][5] The loss of sensory, motor, and reflex function during spinal shock may obscure the usual signs of significant blunt abdominal trauma. 4 Pain has been shown to be an unreliable symptom of abdominal injury in these patients. 14 Hypotension, which may be a result of either neurogenic shock or the presence of an IAI, may add confusion to the evaluation.…”

Section: Discussionmentioning

confidence: 99%

“…14 Hypotension, which may be a result of either neurogenic shock or the presence of an IAI, may add confusion to the evaluation. 4,13 This difficulty in assessing the abdomen often leads to a delay in diagnosis. It has been well established that any delay in diagnosis and therapy of hollow viscus injuries (specifically greater than 8 hours after admission) leads to an increase in morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

“…T HE DIFFICULTY IN ASSESSING the abdomen in patients with spinal cord injury (SCI) has been well documented. [1][2][3][4] Patients with complete SCI above the T7 level have been shown to lose sensory, motor, and reflex functions of the abdominal wall. 1 The net result is an unreliable physical examination that can complicate the diagnosis of abdominal trauma.…”

mentioning

confidence: 99%

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Intraabdominal Injury is Common in Blunt Trauma Patients who Sustain Spinal Cord Injury

Salim

Ottochian

Gertz

et al. 2007

The American Surgeon

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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.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Intraabdominal Injury is Common in Blunt Trauma Patients who Sustain Spinal Cord Injury

Salim

Ottochian

Gertz

et al. 2007

The American Surgeon

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“…This must not be assumed to indicate absence of major abdominal injury. Tibbs et al showed that hypotension was not a reliable indicator of intraperitoneal haemorrhage in spinal cord injury 3 . Loss of sensory and motor reflex function may mask findings in the acute abdomen.…”

Section: Discussionmentioning

confidence: 99%