[Diagnostic and therapeutic strategy by patients with abdominal and thoracoabdominal traumas]

The pointed tendency towards increasing incidence and heaviness of the trauma patients in the last decades led to the emphatic increasement of the hospitalized patients with abdominal and/or thoracoabdominal trauma. For the time-period 1990-2000 total 431 pts with abdominal trauma were admitted. 283 of them underwent operative intervention. Male--221 and female--62, aged from 15 to 83 years (mainly pts under 40 years--188--66.43%). With blunt abdominal trauma were 164 pts (115 male and 49 female); with open wound trauma--119 (107 male and 12 female). According to the injured organ the distributiOn of the patients was: liver--61; spleen--47; pancreas--6; stomach--16; duodenum--2; small intestine--32; colon--27; diaphragm--18; mesenterium--33; omentum--21; kidney--4; "lucky" penetrating wounds--12. Most valuable for the exact diagnosis were: careful examination of the patient, U S, Plain abdominal X-ray, Abdomenocenthesis (68 pts), Laparoscopy (34 pts), Thoracoscopy (16 pts). Almost all of the patients underwent operative procedure during the first 12 hours (276 pts), and even in 45% of them, operation was performed in the first 2-4 h. Intraoperative autohaemotransfusion was performed in 19 pts with parenchymal lesions (liver and spleen). Reoperations were performed in 9 pts (3.53%). Postoperative morbidity--13.78%, and postoperative mortality--4 pts (1.41%).