Intra-abdominal gastrointestinal tract injuries following blunt trauma: the experience of an Australian trauma centre

Hughes, Michael; Elton, Colin; Hitos, Kerry; Pérez, Javier; McDougall, Patricia

doi:10.1016/s0020-1383(02)00068-2

Cited by 53 publications

(43 citation statements)

References 68 publications

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“…Moreover, clinical assessment can be unreliable in patients following blunt trauma due to distracting injuries, head and spinal cord injuries, and shock. Less than 50% of gastrointestinal tract injuries resulting from blunt trauma are reported to have sufficient clinical findings to indicate the need for laparotomy [10] . In this study, 3 patients with unstable haemodynamics undergoing immediate laparotomy (< 2 h) showed marked evidence for abdominal injury.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and management of colonic injuries following blunt trauma

Zheng

Chen²,

Tao³

et al. 2007

WJG

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AIM:To retrospectively evaluate the preoperative diagnostic approaches and management of colonic injuries following blunt abdominal trauma. METHODS:A total of 82 patients with colonic injuries caused by blunt trauma between January 1992 and December 2005 were enrolled. Data were collected on clinical presentation, investigations, diagnostic methods, associated injuries, and operative management. Colonic injury-related mortality and abdominal complications were analyzed. RESULTS:Colonic injuries were caused mainly by motor vehicle accidents. Of the 82 patients, 58 (70.3%) had other associated injuries. Laparotomy was performed within 6 h after injury in 69 cases (84.1%), laparoscopy in 3 because of haemodynamic instability. The most commonly injured site was located in the transverse colon. The mean colon injury scale score was 2.8. The degree of faecal contamination was classified as mild in 18 (22.0%), moderate in 42 (51.2%), severe in 14 (17.1%), and unknown in 8 (9.8%) cases. Sixty-seven patients (81.7%) were treated with primary repair or resection and anastomosis. Faecal stream diversion was performed in 15 cases (18.3%). The overall mortality rate was 6.1%. The incidence of colonic injuryrelated abdominal complications was 20.7%. The only independent predictor of complications was the degree of peritoneal faecal contamination (P = 0.02). CONCLUSION:Colonic injuries following blunt trauma are especially important because of the severity and complexity of associated injuries. A thorough physical examination and a combination of tests can be used to evaluate the indications for laparotomy. One stage management at the time of initial exploration is most often used for colonic injuries.

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Section: Discussionmentioning

confidence: 99%

Diagnosis and management of colonic injuries following blunt trauma

Zheng

Chen²,

Tao³

et al. 2007

WJG

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“…Pelvik fraktür varlığında ise rektum yaralanması gelişebilir. 33 İntestinal ve mezenterik yaralanmaların tanısı semptomların geç ortaya çıkabilmesi nedeniyle zordur. Fizik muayenenin sensitivite ve spesifitesi yoktur.…”

Section: Barsak Ve Mezenterunclassified

Computed tomography findings of abdominal trauma

Önder¹,

Kuday²,

Gür³

et al. 2012

Sakarya Med J

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ÖzetKarın travmaları; baş, boyun ve toraks travmalarından sonra üçüncü en sık ölüm nedenidir. Travmalara bağlı ölümlerin yaklaşık % 10' u abdominal yaralanmalara bağlı gelişir. Künt solid organ yaralanmalarının nonoperatif tedavisinin önünü açan en büyük faktör Bilgisayarlı Tomografi(BT) olmuştur. BT, yaralanmaların anatomisini doğru bir şekilde ortaya koyar. İntraperito-neal sıvının miktarı, retroperitoneal yapılar ve gastrointestinal sistem hakkında çok önemli bil-giler verir. Günümüzde BT olmadan solid organ yaralanmalarının konservatif tedavisinin gerçekleştirilmesi çok güçtür. BT karaciğer, dalak, böbrek, pankreas ve sindirim borusunun trav-ma sonrası evrelemesi tedavi ve takibinde önemli katkılar sağlamaktadır. AbstractAbdominal trauma, the third most common cause of death after head, neck and chest in-juries. %10 of trauma related deaths develops due to abdominal injury. Computed Tomography (CT) has been paving the biggest factor in the way for nonoperative treatment of blunt solid organ injuries. CT exposes accurately to the anatomy of injuries. It is provide very important information about, the amount of intraperitoneal fluid, retroperitoneal structures, and the gastrointestinal system. Today, it is very difficult the realization of solid organ injury with conservative treatment without CT. CT provides a significant contribution staging of trauma liver, spleen, kidney, pancreas and digestive tract, treatment and follow-up. Keywords GirişKarın travmaları; baş, boyun ve toraks travmalarından sonra travmalara bağlı ölüm nedenleri içerisinde üçüncü sıklıktadır. Travmalara bağlı ölümlerin yaklaşık % 10' u abdominal yaralanmalara bağlı gelişir.1,2 Karın travmaları kafa ve göğüs travmalarından daha az ölümcül olmalarına rağmen, kendisine bağlı ölümlerin erken tanı ve tedavisi yapıldığında en yüksek oranda önlenebilir travma grubu olması nedeni ile önemini korumaktadır.3 Oluş mekanizması bakımından trafik kazaları, iş kazaları, yüksekten düşme ve darp gibi olaylar künt travma grubuna girerler. Künt solid organ yaralanmalarında, Avrupa ülkelerinde olduğu gibi, ülkemizde de trafik kazaları en ön sırayı almaktadır. 4Künt solid organ yaralanmalarının nonoperatif tedavisinin önünü açan en büyük faktör Bilgisayarlı Tomografi (BT) olmuştur. BT; yaralanmaların anatomisini doğru bir şekil-de ortaya koyar.

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“…These lesions occur as a result of high energy trauma involving motor vehicle accidents in 70-90% of cases. [2][3][4][5][6][7][8][9] The most common cause of HVI in our study is RTA (70%) and most of the patients were young and there is a need to focus on the preventive aspects also.…”

Section: -5mentioning

confidence: 74%

Hollow viscus injury due to blunt abdominal trauma

et al. 2017

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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.

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Intra-abdominal gastrointestinal tract injuries following blunt trauma: the experience of an Australian trauma centre

Cited by 53 publications

References 68 publications

Diagnosis and management of colonic injuries following blunt trauma

Diagnosis and management of colonic injuries following blunt trauma

Computed tomography findings of abdominal trauma

Hollow viscus injury due to blunt abdominal trauma

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