Management of blunt bowel and mesenteric injuries: Experience at the Alfred Hospital

Alsayali, Mashal M.; Atkin, Christopher; Winnett, Jason; Rahim, Reza; Niggemeyer, Louise E.; Kossmann, Thomas

doi:10.1016/j.injury.2009.01.070

Cited by 4 publications

(5 citation statements)

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“…On the other hand, the frequency of EOH that we have reached is still higher than that reported from some other developing countries, in Saudi Arabia the reported frequency of EPH is (0.33/1000 deliveries) , (4) in Dubai (0.47/1000 deliveries (2) and UAE ( 1.5/1000 deliveries) (29) The difference in the incidence of EOH may be explained by the different levels of sophistication in obstetric health care and patient load. Another factor that attributed is to an increase in the frequency of EOH may be the increase in the number of un-booked cases for antenatal care and also our hospital is a referral hospital in this region and the increase in the number of referred cases with detrimental moribund health conditions after complications occurred.…”

Section: Subtotalcontrasting

confidence: 78%

“…Similar results have been reported by different studies from Aden, Pakistan, (5,17,19) whereas the most frequent indications reported from the developing countries were morbid adherence of placenta and uterine atony. ( 16,20) These data are not concomitant to that found in studies from Saudi Arabia, (4 ) Duabia (2) , Republic of Korea (6) as uterine atonia appear to be the most common cause. Univ.…”

Section: Subtotalcontrasting

confidence: 55%

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Emergency obstetric hysterectomy: five years review at Al Sadaqa teaching hospital

Al.kaaky

2019

Univ. Aden J. Nat. and Appl. Sc.

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Emergency hysterectomy in obstetrics is rarely indicated and is always debatable. The aim of the study is to determine the incidence, sociodemographic factors, indications, maternal characteristics and maternal and perinatal outcome of emergency obstetric hysterectomy. This is a retrospective hospital based study of the cases of emergency obstetric hysterectomy performed over a period of 5 years from Jan 2014 to November 2018. A total of 55 cases of emergency obstetric hysterectomy (EOH) were studied in the Department of Obstetrics and Gynecology, in a Al-Sadaqa Teaching Hospital, Aden. During the study period there were 55 emergency obstetric hysterectomies and 33903 deliveries, giving an incidence of 0.16% or 1.6/1000. The majority of the cases were unbooked (36.4%). It was more common in multipara and grandmultipara (57.3%). Ruptured uterus (60.0%) , atonics postpartum hemorrhage (10.9%) and morbidly adherent placenta (9.1%) were the common indications. Subtotal hysterectomy was performed in 69.1% of the cases and total hysterectomy in the rest. The perinatal mortality was (67.0%), and the maternal mortality was 1.8%. Emergency obstetric hysterectomy is a lifesaving procedure. Uterine rupture, uterine atonia and morbid adherent placenta are the leading indications for emergency obstetric hysterectomy.

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Section: Subtotalcontrasting

confidence: 78%

Section: Subtotalcontrasting

confidence: 55%

Emergency obstetric hysterectomy: five years review at Al Sadaqa teaching hospital

Al.kaaky

2019

Univ. Aden J. Nat. and Appl. Sc.

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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: 75%

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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“…Emergency obstetric hysterectomy was first performed in the 19th century to lessen the high maternal mortality and morbidity related with the caesarian delivery. The indications were mainly grave sepsis and hemorrhag 3 . Subsequently common indications for emergency peripartum hysterectomy were uterine rupture and uterine atony 4. Over the past 2-3 decades indication for hysterectomy were uncontrollable haemorrhage due to placenta accreta or uterine atonia 5 .…”

Section: Introductionmentioning

confidence: 99%

Emergency Obstetric Hysterectomy

Ara

Umbreen

Fouzia

2015

TPMJ

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Background: Emergency hysterectomy in obstetric practice is generallyperformed in the setting of life-threatening hemorrhage which fails to be controlled byconservative management. Objective: To review 8 years’ experience of emergency obstetrichysterectomy in a teaching hospital. Study Design: A retrospective descriptive study based onhospital data of 156 patients undergoing emergency Obstetric hysterectomy. Settings: Obs. &Gynae. Department Unit-I, PMC Allied Hospital Faisalabad. Methods: This was a retrospectivereview carried out from March 2004 to Feb 2012 Main outcome measures were frequency,indications, associated risk factors and maternal morbidity and mortality associated withemergency peripartum/obstetric hysterectomy. Results: During 8 years there were total 156(0.38%, 3.8 per 1000) emergency obstetric hysterectomies out of which there were 46 caesarianhysterectomies, 65 post partum, 45 for ruptured uterus with total number of delivery 40062.Number of hysterectomies was 48 in the first 4 years of the study (March 2004- Feb 2008) andduring the last 4 years (March 2008- Feb 2012) it was 108. Maximum obstetric hysterectomieswere in para 3-5 (53.20%) and in 26-30 years age group (35.89%). The most common indicationfor hysterectomy was uterine atony (44.23%) followed by uterine rupture (28.85%), Placentaaccreta (14.745%) and placenta previa (11.53%). The maternal mortality was 6.41% (10patients). In this series 80% patients were referred from other areas. Conclusions: Frequencyof emergency Obstetric hysterectomy is high in our tertiary center and it is continuouslyincreasing due to increased referral of patients. The mortality and morbidity of performingobstetric hysterectomy is higher in patients referred from outside hospital.

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Management of blunt bowel and mesenteric injuries: Experience at the Alfred Hospital

Cited by 4 publications

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Emergency obstetric hysterectomy: five years review at Al Sadaqa teaching hospital

Emergency obstetric hysterectomy: five years review at Al Sadaqa teaching hospital

Hollow viscus injury due to blunt abdominal trauma

Emergency Obstetric Hysterectomy

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