The European journal of surgery = Acta chirurgica · 2001
Mesenteric injury after blunt abdominal trauma.
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Xeropotamos N S, Nousias V E, Ioannou H V, Kappas A M
Аннотация
OBJECTIVE: To present our experience of mesenteric injuries after blunt abdominal trauma.
DESIGN: Retrospective study.
SETTING: University hospital, Greece.
SUBJECTS: 31 patients with mesenteric injuries out of 333 who required operations for blunt abdominal trauma between March 1978 and March 1998. 21 were diagnosed within 6 hours (median 160 min, early group) and in 10 the diagnosis was delayed (median 21 hours, range 15 hours-7 days, delayed group).
INTERVENTIONS: Emergency laparotomy.
MAIN OUTCOME MEASURES: Mortality, morbidity, and hospital stay.
RESULTS: There were no deaths. The diagnosis was confirmed by diagnostic peritoneal lavage in 17/21 patients in the early group whereas 7/10 in the delayed group were diagnosed by clinical examination alone. Most of the injuries (n = 23) were caused by road traffic accidents. 30 patients had injured the small bowel mesentery and 4 the large bowel mesentery. 25 of the 31 patients had associated injuries. There were no complications in the early group, compared with 6 wound infections and 1 case of small bowel obstruction in the delayed group (p < 0.0001). Median hospital stay in the early group was 11 days (range 3-24) compared with 23 days (range 10-61) in the delayed group (p = 0.004).
CONCLUSION: Because delay in diagnosis is significantly associated with morbidity and duration of hospital stay we recommend that all patients admitted with blunt abdominal trauma should have a diagnostic peritoneal lavage as soon as possible
DESIGN: Retrospective study.
SETTING: University hospital, Greece.
SUBJECTS: 31 patients with mesenteric injuries out of 333 who required operations for blunt abdominal trauma between March 1978 and March 1998. 21 were diagnosed within 6 hours (median 160 min, early group) and in 10 the diagnosis was delayed (median 21 hours, range 15 hours-7 days, delayed group).
INTERVENTIONS: Emergency laparotomy.
MAIN OUTCOME MEASURES: Mortality, morbidity, and hospital stay.
RESULTS: There were no deaths. The diagnosis was confirmed by diagnostic peritoneal lavage in 17/21 patients in the early group whereas 7/10 in the delayed group were diagnosed by clinical examination alone. Most of the injuries (n = 23) were caused by road traffic accidents. 30 patients had injured the small bowel mesentery and 4 the large bowel mesentery. 25 of the 31 patients had associated injuries. There were no complications in the early group, compared with 6 wound infections and 1 case of small bowel obstruction in the delayed group (p < 0.0001). Median hospital stay in the early group was 11 days (range 3-24) compared with 23 days (range 10-61) in the delayed group (p = 0.004).
CONCLUSION: Because delay in diagnosis is significantly associated with morbidity and duration of hospital stay we recommend that all patients admitted with blunt abdominal trauma should have a diagnostic peritoneal lavage as soon as possible
Предметные рубрики MeSH
Abdominal InjuriesAdolescentAdultAgedAged, 80 and overChildChild, PreschoolComorbidityEmergency TreatmentFemaleFollow-Up StudiesGreeceHumansIncidenceInjury Severity ScoreLaparotomyMaleMesenteryMiddle AgedPeritoneal DiseasesProbabilityRisk AssessmentTime FactorsTreatment OutcomeWounds, Nonpenetrating