DIAGNOSTIC AND TREATMENT OPTIONS OF BLUNT ABDOMINAL TRAUMA IN A REGIONAL HOSPITAL
Authors:
Michal Kristen; Zuzana Šerclová
Authors place of work:
Surgical department Hospital Hořovice, a. s.
; Chirurgické oddělení, NH Hospital a. s.
Published in the journal:
Úraz chir. 24., 2016, č.2
Summary
The aim of the study:
The evaluation of diagnostic and treatment possibilities and procedures in the regional Hořovice Hospital.
This is a retrospective analysis of a group of 39 patients treated in Hořovice Hospital from January 1, 2010 to August 31, 2015 for blunt abdominal trauma.
Materials and methods:
From January 2010 until the end of August 2015, there were 449 patients treated with the initial diagnosis of blunt abdominal trauma in Hořovice Hospital. In 39 patients, injuries of the abdomen or retroperitoneum were confirmed, of whom 10 were women and 29 men. The median age of the patient population was 52 (15-87) years. The most common cause of injury was a fall from a height. In 13 cases, it was only an isolated injury, in 26 cases also injuries of other body regions were observed. Most frequently the combination blunt abdominal trauma-chest injury was seen. The median ISS was 13 (4-27). The median length of hospitalization was 10 (1-77) days.
Results:
Diagnosis of abdominal organ injury was based of clinical examination and medical imaging. 37 patients had a CT scan with a contrast media, while 35 patients had ultrasound examinations, one underwent MRI scan and one ERCP. Urgent surgical treatment was indicated for 8 patients. 5 patients were transferred to a higher-level facility. 27 patients were primarily treated conservatively. From the group of conservatively treated patients, surgical treatment was later indicated in 5 patients. Altogether, we successfully treated without complication 33 (84.6 %) patients.
Conclusion:
Isolated injuries to parenchymatous organs with a degree of damage from I to III and milder associated injuries not exceeding ISS 16 can be safely diagnosed and treated at a regional hospital. Patients with more severe injuries classified with degrees IV and V, which are often part of polytrauma, should be primarily directed to trauma centers.
Key words:
Blunt abdominal trauma, CT scan, conservative treatment, surgical treatment.
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Štítky
Surgery Traumatology Trauma surgeryČlánok vyšiel v časopise
Trauma Surgery
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