By Harry M. Delany M.D., F.A.C.S., Robert S. Jason M.D. (auth.)
Trauma to the stomach, either unintended and willful, has develop into more and more universal during this period of accelerating violence. huge numbers of sufferers everywhere in the state are admitted to emergency rooms due to stomach trauma of various levels of severity. All too frequently the proper prognosis is suspected belatedly or certainly not, in order that right remedy isn't initiated in enough time to be lifesaving. now not infre quently, the injured sufferer is tested by means of an intern or an insufficiently skilled resident general practitioner. Even in situations the place extra senior internists and surgeons can be found, precise wisdom concerning the worthwhile method to set up the right kind prognosis and institute the ideal remedy is missing. This monograph, representing the felicitous collaboration of a health care provider and a radiolo gist including a number of different members, is well timed and critical. The authors (and their participants) have approached their topic with a wealth of scientific experi ence got in numerous very energetic acute-care municipal hospitals within the greatest urban during this state. they've got saw and handled a really huge variety of sufferers with a large number of anxious explanations, together with firearm accidents, stab wounds, vehicular injuries, falls, and attacks. The authors have divided this paintings into 4 major sections: basic views on belly damage, forms of belly accidents, particular Diagnostic innovations, and particular Organ or Supporting-Structure Injury.
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Extra resources for Abdominal Trauma: Surgical and Radiologic Diagnosis
Sample text
J Trauma 17: 903-907 208 Source: Fitzgerald JB, Quast DC, Beahl AC, DeBakey ME (1965) Surgical experi· ence with 103 truncal shotgun wounds. J Trauma 5: 72 in the latter. Lowe et al. reviewed the problem of selectivity in the management of gunshot-wound patients [22]. Aside from a lower mortality, stab wounds had a one-third incidence of significant abdominal injury in their series. 8%. 25). 25. 9%) 385 Source: Lowe RJ, Salletta JD, Read DR, Radhakrishnan J, Moss GS (1977) Sould laparotomy be mandatory or selective in gunshot wounds of the abdomen.
35. Reynolds BM, Balsam NA, Reynolds FX (1971) Falls from heights: A surgical experience of 200 consecutive cases. Ann Surg 174: 304 36. Richter RM, Zachy MH (1967) Selective conservative management of penetrating abdominal wounds. Ann Surg 166: 238-244 37. Ryzoff RI, Shaftan GW, Herbsman H (1966) Selective conservatism in penetrating abdominal trauma. Surgery 59: 650-653 38. Shaftan GW (1960) Indications for operation in abdominal trauma. Am J Surg 99: 657-664 39. Shaftan GW (1969) Editorial: Selective conservatism in penetrating abdominal trauma.
To perform this examination, a catheter is snugly fitted into the penetrating abdominal wound and secured to the wound edges by surgical suture material; 50-60 cc of urographic water-soluble contrast material is then injected under pressure through the catheter and into the wound. Penetrating injury to the abdominal cavity can be demonstrated by the intraperitoneal spread of contrast to outline loops of bowel and other abdominal viscera. In experienced hands the examination has an accuracy rate of 90%.