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Acute gastric dilatation after trauma.
T H Cogbill1, M Bintz, J A Johnson
1Department of Surgery, Gundersen Clinic/La Crosse Lutheran Hospital, WI 54601.
The Journal of Trauma
|October 1, 1987
Summary
Acute gastric dilatation is common in trauma patients, especially children. Early nasogastric tube placement is recommended to prevent complications like aspiration and aid abdominal assessment.
Area of Science:
- Trauma Surgery
- Gastroenterology
- Emergency Medicine
Background:
- Multiple trauma patients frequently develop acute gastric dilatation.
- This condition can complicate patient management and diagnostic assessments.
Purpose of the Study:
- To determine the incidence of acute gastric dilatation in multiply injured patients.
- To identify associated risk factors and complications.
- To evaluate the effectiveness of nasogastric tube management.
Main Methods:
- Retrospective review of 248 consecutive multiple trauma admissions over 2 years.
- Analysis of roentgenograms for acute gastric dilatation.
- Correlation of gastric dilatation with injury type, severity, and patient demographics.
Main Results:
- Acute gastric dilatation occurred in 27% of patients, with higher incidence in children (44%) vs. adults (25%).
- Motor vehicle accidents were the most common mechanism of injury.
- Complications included pulmonary aspiration (4%), gastric hemorrhage (4%), and prolonged ileus (18%).
Conclusions:
- Acute gastric dilatation is a frequent complication in trauma patients, particularly in rural settings.
- Early nasogastric tube insertion is advised unless contraindicated.
- Prompt management can mitigate associated risks and improve diagnostic accuracy.