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Abdominal vascular injuries.

R B Adkins, E L Bitseff, P W Meacham

    Southern Medical Journal
    |October 1, 1985
    PubMed
    Summary
    This summary is machine-generated.

    Major abdominal vascular injuries, often from trauma in young men, require rapid stabilization and hypotension reversal, like with Military Anti-Shock (MAS) trousers, to improve survival rates. Prompt surgical intervention is crucial, though emergency room thoracotomy has limited application.

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    Area of Science:

    • Trauma Surgery
    • Vascular Surgery
    • Emergency Medicine

    Background:

    • Major abdominal vascular injuries present significant treatment challenges.
    • Historically, these injuries are often associated with high morbidity and mortality.
    • Penetrating trauma is a leading cause, predominantly affecting young males.

    Purpose of the Study:

    • To review the institutional experience with major abdominal vascular injuries.
    • To identify factors influencing survival in patients with these injuries.
    • To evaluate the role of specific interventions like Military Anti-Shock trousers and emergency room thoracotomy.

    Main Methods:

    • Retrospective review of 93 patients treated for 147 abdominal vascular injuries from 1973 onwards.
    • Analysis of injury mechanisms, affected vessels, treatment strategies, and outcomes.

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  • Specific evaluation of Military Anti-Shock (MAS) trousers and emergency room (ER) thoracotomy use.

    • Main Results:

    • 67% of injuries resulted from penetrating trauma in young men (21-30 years).
    • Iliac vessels (36%) and inferior vena cava (20%) were most frequently injured.
    • Overall mortality was 29%; suture repair was successful in 61%, ligation in 26%.
    • MAS trousers use in hypotensive patients showed a 50% survival rate.
    • ER thoracotomy for refractory hypotension/cardiac arrest had 100% mortality.

    Conclusions:

    • Rapid stabilization, hypotension reversal (e.g., MAS trousers), and coagulopathy prevention are key to improving survival.
    • Prompt surgical exploration is essential.
    • ER thoracotomy has a very limited role in managing these complex injuries.