Outcome of open abdominal management following military trauma

Pengelly, Steven; Berry, James E.; Herrick, Sarah E.; Bowley, Douglas M.; Carlson, Gordon L

doi:10.1002/bjs.10813

Cited by 6 publications

(2 citation statements)

References 25 publications

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“…The relative mobility in the abdominal cavity, the volume of the organ and the surface area, the nature of the content in the lumen of the intestines, the peculiarities of angioarchitectonics -all this determines the low threshold of resistance to the effects of barotrauma. This is evidenced by the small but proven number of primary ruptures of the intestinal wall [4,13]. The intestinal wall has its "weak" places, namely the submucosal layer, where the submucosal microcirculatory vascular plexus is located, the place where the mesentery is attached.…”

Section: Discussionmentioning

confidence: 99%

Correlational relationships of intestinal wall parameters after barotraum

Kosharniy¹,

Abdul-Ogli²,

Козлов³

et al. 2023

Rep. of Morph.

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Explosions are physical phenomena that lead to a sudden release of energy; they can be chemical, nuclear or mechanical. This process results in an almost instantaneous increase in pressure above atmospheric pressure. Damage to the abdominal organs after the action of explosion factors (shock blast wave, striking elements of the explosive device, secondary shells, chemical and thermal factors) is a fairly common clinical situation. The small and large intestines are the most vulnerable to the impact of a shock blast among the abdominal organs. The aim of the study was a study of the distant consequences of the influence of barotrauma on the morphometric parameters of the intestines of white rats and their correlations. The studies were performed on 20 white outbred sexually mature rats weighing 180-200 g. The wall of the small intestine was stained with hematoxylin and eosin according to the generally accepted method. The thickness of the entire intestinal wall, mucous, muscular and serous membranes, the length and width of the villi, the depth and width of the crypts were determined. Statistical processing of morphometry results was performed using the Statistica 10.0 program. Analysis of histopathological changes in the wall of the small intestine by light microscopy on the seventh day after the impact of the shock air wave on the anterior abdominal wall showed a significant thickening of the mucous membrane, submucosa, muscle membrane compared with the control group of animals. Thickening of the intestinal wall layers occurred due to intercellular edema and edema of stromal elements. At the time of the study, an inflammatory reaction with predominantly neutrophilic infiltration was present in all mucosal, submucosal, and muscular membranes. From the vascular bed in the vessels of the mucous and submucosal membranes, circulatory disorders occurred in the form of plethora and stasis in the vessels of various diameters and affiliations. Thickening of the layers of the intestinal wall occurred due to intercellular edema, swelling of stromal elements. The analysis of the morphometric parameters of the wall of the small intestine showed that in experimental rats after barotrauma simulation, quantitative changes occur at both the cellular and tissue levels, which correlate with the observation period. The muscular shell is subject to more pronounced changes under the action of a shock wave, which is confirmed by morphometric studies and correlation analysis. When conducting a correlation analysis, it was established that all indicators had strong positive relationships with each other, except for the parameter of the thickness of the muscle layer. Changes in the average thickness of the mesenteric layer had a moderate relationship with all parameters except crypt width and mucosal thickness.

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Section: Discussionmentioning

confidence: 99%

Correlational relationships of intestinal wall parameters after barotraum

Kosharniy¹,

Abdul-Ogli²,

Козлов³

et al. 2023

Rep. of Morph.

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“…Dicho estudio concluye que el cierre secuencial mejora la posibilidad de una eventual reconstrucción de la pared abdominal sin mejorar la incidencia de hernia incisional ya que no hubo diferencia estadísticamente significativa entre el el grupo de cierre primario y el cierre secuencial. 22 Explosivos en el piso, como las minas antipersona, al ser detonadas, además de comprometer piernas y genitales, pueden ocasionar lesiones colorrectales comprometiendo la integridad del tracto gastrointestinal bajo. Ante dicha situación los cirujanos pueden optar por un reparo primario o por una derivación entérica en un primer momento quirúrgico para realizar una reconstrucción cuando el paciente no se encuentre en un estado catabólico.…”

Section: Mecanismos Cuaternario Y Quinariounclassified

Trauma Por Onda Explosiva La Mirada Del Cirujano General En La Práctica Civil

Gomez¹,

Mendoza²,

Pulido³

2015

Panamerican Journal of Trauma, Critical Care &Amp; Emergency Surgery

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Introducción: Onda explosiva se define como la liberación violenta de energía que es transferida hacia el ambiente; siendo esta capaz de empujar columnas de aire, material particulado y gases calientes que al encontrarse con el cuerpo humano ocasionan lesiones que pueden llegar a comprometer la vida. Materiales y métodos: Se presenta una revisión narrativa de la literatura con herramientas de revisión sistemática sobre el tema de trauma por onda expansiva. Excluyendo artículos no relacionados con trauma por onda expansiva publicados en idiomas diferentes al español y al inglés y aquellos cuya temática central es diferente de lo tratado por la cirugía general y sus subespecialidades. Discussion: Se describe cada uno de los 5 mecanismos de lesión descritos para este tipo de trauma, y se hace un resumen del diagnóstico y manejo de las lesiones más frecuentes a nivel torácico, abdominal y vascular periférico. Conclusión: Es esencial conocer los mecanismos de lesión para dar el manejo adecuado a los pacientes víctimas de este tipo de lesiones de una manera multidisciplinaria.

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