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[Blunt injuries of the abdomen in Gorenjsko during the past 3 years]
Insights
Prompt diagnosis of blunt abdominal injuries is crucial for reducing patient morbidity. Abdominal lavage, alongside physical evaluation, aids in early and accurate diagnosis, leading to better patient outcomes.
Area of Science:
- Trauma Surgery
- Abdominal Injuries
- Diagnostic Procedures
Context:
- Review of 131 blunt abdominal injury cases treated over three years in Gorenjska, Slovenia.
- Analysis of surgical interventions and diagnostic methods employed.
- Focus on spleen, liver, and small intestine as most frequently injured organs.
Purpose:
- To highlight the significance of early and accurate diagnosis in managing blunt abdominal trauma.
- To evaluate the efficacy of abdominal lavage as a diagnostic tool.
- To present treatment strategies for various abdominal organ injuries.
Summary:
- 51 out of 131 patients underwent surgery, with 5 exploratory laparotomies revealing no pathology.
- Abdominal lavage was utilized in all suspected acute abdomen cases, yielding excellent diagnostic results.
- Treatment modalities included necrectomy, vessel ligation, suturing, drainage, and in severe cases, hepatic artery ligation and resection.
Impact:
- Emphasizes abdominal lavage as a key procedure for prompt diagnosis in blunt abdominal trauma.
- Demonstrates that timely diagnosis and intervention significantly reduce patient morbidity.
- Provides insights into surgical management of liver, spleen, and pancreatic injuries.
Abstract:
This paper concerns blunt injuries of the abdomen in Gorenjsko (a Region of SR Slovenija northern of Ljubljana) treated during the past 3 years. Of the total 131 hospitalized patients, 51 (or 43.5%) were operated on. In 5 (8,8%) an explorative lapartomy was performed in which no pathological substrate was found. The most frequent lesions were found in the spleen, liver and small intestine. The paper stresses the importance of an early and correct diagnosis of such injuries. In making the exact diagnosis aside from the physical evaluation, the most important procedure is lavagage of the abdomen which the authors used in all cases suspect for acute abdomen and obtained excellent results. In 20% of the patients surgery was performed within 2 hours of their of hospital admission. Injuries of the liver were treated with necrectomy, ligature of the bleeding vessels, suturing of the biliary canals, and establishment of drainage. Ligation of the hepatic artery and hepatic resection was performed in two cases. Injuries of the pancreas were also treated with necrectomy, hemostasis and drainage. In one case with a posttraumatic pseudocyst of the pancreas surgery was performed with an isolated intestinal loop according to Roux-Herzen. In conclusion the author insists on a prompt diagnosis in which abdominal lavage plays an important role. Using such an approach the morbidity is significantly reduced.