By Harry M. Delany M.D., F.A.C.S., Robert S. Jason M.D. (auth.)
Trauma to the stomach, either unintended and willful, has develop into more and more universal during this period of accelerating violence. huge numbers of sufferers everywhere in the kingdom are admitted to emergency rooms due to belly trauma of various levels of severity. All too frequently the proper analysis is suspected belatedly or under no circumstances, in order that right remedy isn't really initiated in adequate time to be lifesaving. now not infre quently, the injured sufferer is tested via an intern or an insufficiently skilled resident general practitioner. Even in cases the place extra senior internists and surgeons can be found, unique wisdom in regards to the invaluable method to set up the proper analysis and institute the correct remedy is missing. This monograph, representing the felicitous collaboration of a general practitioner and a radiolo gist including numerous different individuals, is well timed and demanding. The authors (and their members) have approached their topic with a wealth of medical experi ence bought in numerous very energetic acute-care municipal hospitals within the biggest urban during this nation. they've got saw and taken care of a truly huge variety of sufferers with a mess of demanding explanations, together with firearm accidents, stab wounds, vehicular injuries, falls, and attacks. The authors have divided this paintings into 4 major sections: common views on stomach damage, varieties of stomach accidents, particular Diagnostic options, and particular Organ or Supporting-Structure Injury.
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Additional resources for Abdominal Trauma: Surgical and Radiologic Diagnosis
A B Physical Diagnosis 43 have been reported by a number of authors and are described elsewhere in this work. Alcoholism and drug intoxication are commonly coexisting problems in the urban traumatized patient. Both forms of intoxication may alter levels of consciousness and physical findings. For example, acute alcoholism may reduce the patient's blood pressure and thus suggest traumatic hypovolemia. In such a situation judging the degree of blood loss may be difficult. If the hypotensive traumatized patient has not lost a significant quantity of intravascular volume, an immediate response to I liter of crystalloid resuscitation fluid will be apparent.
Stab wounds: Radiographic examination vs selective management (7/1/66-8/31/68) Total: 155 I I Radiographic I Selective 67 . 88 I No Peritoneal penetration hypaque penetration hypaque 40 47 I Visceral injury 33 I False negative 1 Clinical signs neg. for lapa. 41 Clinical signs pos. for lapa. 3%) Source: Steichen FM, Efron G, Pearlman DM, Wei! PH (1969) Radiographic diagnosis vs selective management in penetrating wounds of the abdomen. 20. Gunshot wounds: Radiographic examination vs selective management (7/1/66-8/31/68) , Total: 33 Peritoneal penetration hypaque 1 I Radiographic Selective 6 27 I No penetration hypaque 5 False negative o 19 !
For lapa. 21 Clinical signs neg. for lapa. 5 I (Visceral injury) Visceral injury 20 False negative 1 No visceral injury 1 Source: Steichen FM, Efron G, Pearlman DM, Wei! PH (1969) Radiographic diagnosis vs selective management in penetrating wounds of the abdomen. Ann Surg 170(6): 978-983 20 Types of Abdominal Injury as the basis for operative intervention appears to be current, debate over the proper approach to penetrating abdominal injuries has existed for many years. The present debate over selectivity and the conservative management of stab wounds has been accompanied by rapid progress in the development of adjunctive diagnostic techniques applicable to patients suffering abdominal trauma.