ABDOMINAL HEMORRHAGE IN CASE OF CATATRAUMA

Area of Science:

• Trauma Surgery
• Emergency Medicine
• Diagnostic Imaging

Background:

• Abdominal multitrauma presents diagnostic and therapeutic challenges.
• Hemorrhage from parenchymal organ injury is common in abdominal trauma.
• Accurate diagnosis is critical for effective management of blunt abdominal trauma.

Purpose of the Study:

• To analyze diagnostic and treatment outcomes in patients with abdominal multitrauma.
• To evaluate the efficacy of different diagnostic modalities, including ultrasound (USS), in identifying hemoperitoneum.
• To propose a treatment algorithm for closed abdominal injuries based on hemoperitoneum assessment.

Main Methods:

• Retrospective analysis of 111 patients with abdominal multitrauma (2010-2013).
• Diagnosis based on instrumental investigations, laparoscopy, and clinical symptoms.
• Assessment of diagnostic values for clinical symptoms, radiography, and ultrasound (USS).
• Evaluation of outcomes for laparotomy and laparoscopy, including conversion rates and laparoscopic interventions.

Main Results:

• Ultrasound (USS) demonstrated a high diagnostic value (91.6%) for hemoperitoneum in abdominal trauma.
• Clinical symptoms had limited diagnostic value (45.9%), while radiography ranged from 41.2% to 66.4%.
• Laparoscopy was performed in 66 cases, with 31 experiencing ongoing bleeding, leading to 27 conversions to laparotomy.
• The overall lethality rate was 27%.

Conclusions:

• An algorithm for treating closed abdominal injuries, incorporating score assessment of hemoperitoneum via USS, was proposed.
• This algorithm significantly improved treatment efficacy.
• Implementation of the proposed algorithm led to a decrease in postoperative complications and mortality rates.