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Acute gastric dilation after trauma.

C R Jambor1, D J Steedman

  • 1Department of Accident and Emergency Medicine, Royal Infirmary of Edinburgh, UK.

Journal of the Royal College of Surgeons of Edinburgh
|February 1, 1991
PubMed
Summary

Acute gastric dilatation is common in trauma patients, often without abdominal injury. Early nasogastric tube placement is recommended to prevent complications like pulmonary aspiration and hemorrhage.

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Area of Science:

  • Trauma Surgery
  • Emergency Medicine
  • Gastroenterology

Background:

  • Acute gastric dilatation is a recognized complication in trauma patients.
  • It can occur even without significant abdominal injury.
  • Clinical suspicion and radiological confirmation are key diagnostic steps.

Purpose of the Study:

  • To investigate the incidence and clinical features of acute gastric dilatation in trauma patients.
  • To identify associated injuries and complications.
  • To evaluate the role of nasogastric tube placement in management.

Main Methods:

  • Prospective study of 100 trauma patients admitted to a resuscitation room.
  • Radiological confirmation of acute gastric dilatation.
  • Clinical assessment and review of patient records, including injury severity and interventions.

Main Results:

  • 17 out of 100 patients (17%) had acute gastric dilatation, often without abdominal injury (76%).
  • Clinical suspicion was low (53%).
  • Complications included gastric hemorrhage (35%) and pulmonary aspiration (12%).
  • Early nasogastric tube placement was associated with better outcomes, especially in transferred patients.

Conclusions:

  • Acute gastric dilatation is an underdiagnosed condition in trauma patients.
  • Nasogastric tube insertion is crucial for preventing complications.
  • Early intervention, particularly before inter-hospital transfer, is strongly recommended.

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