The efficacy of serial physical examination in penetrating abdominal trauma

Haarst, Ernst P. van; BEZOOIJEN, B. P. J. van; Coene, Peter-Paul L.O; Luitse, Jan S. K.

doi:10.1016/s0020-1383(99)00159-x

Cited by 53 publications

(41 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The negative laparotomy rates reported in the studies using serial physical examination alone has been less than 5%. [10][11][12][13][14] In this series the negative laparotomy rate for ASW was 28.7 %. This high rate of unnecessary laparotomies is due to the fact that many surgeons working in Kumasi and Accra still adhere to the traditional mandatory laparotomy concept.…”

Section: Discussionmentioning

confidence: 79%

“…The overall survival rate of 85.9% is the same as that from other centres where a policy of selective conservative management of AGW was practiced. [10][11][12][13][14]18 An acceptable survival rate is therefore possible without the practice of a mandatory laparotomy for AGW.…”

Section: Discussionmentioning

confidence: 99%

“…In many trauma centres world-wide, the management of penetrating abdominal injuries remains controversial and subjected to constant reappraisal. [10][11][12][13][14] It is against this background that this study was designed and conducted. This is a report on the pattern and outcome of treatment of penetrating abdominal injuries as seen in the two major communities in Ghana…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Penetrating abdominal injuries in adults seen at two teaching hospitals in Ghana

Ohene-Yeboah

Dakubo²,

Boakye³

et al. 2011

Ghana Medical Journal

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Penetrating abdominal injuries in adults seen at two teaching hospitals in Ghana

Ohene-Yeboah

Dakubo²,

Boakye³

et al. 2011

Ghana Medical Journal

View full text Add to dashboard Cite

“…Van Haarst et al reached similar conclusion (10). The results of 10 years observation involving 370 patients with penetrating abdominal injuries enabled the authors to put forth an idea of conservative treatment with continuous monitoring of patient's condition and systematically performed physical examinations of the abdomen.…”

Section: Discussionmentioning

confidence: 73%

Abdominal Injury. Pathogeniesis and Outcome of the Treatment

Wołoszko¹,

Pogorzelski²,

Brzeziński³

et al. 2008

Polish Journal of Surgery

View full text Add to dashboard Cite

Abdominal injuries seem to appear rather not frequently. In a presented material their prevalence does not exeed 0.3% of all patients. In spite of that they are significant problem of surgical wards on duty for in many cases surgical intervention is necessary. The aim of the study was to assess the extent of required surgical treatment and the results of injury management. Material and methods. 95 patients with abdominal injury were treated in our clinic between years 1996 and 2006 .There were 29 women (30.5%) and 66 males (69.5%) in this group at the age ranging from 17 to 91 years /mean-44 years/. The reasons of the injury were as follow: traffic accidents in 33 patients (34.7%), sudden collapse and the fall from the height in 25 patients (26.3%) and the assault in the rest 32 patients (33.7%). Blunt abdominal trauma was diagnosed in 69 patients (72.6%) while penetrating one in 26 persons (27,4%). Isolated injury to abdominal cavity concerned 35 cases (36,8%) and in the rest 60 cases (63,2%) were poly-trauma patients. Abdominal trauma was accompanied most frequently by chest trauma (34 cases-35.8%), then by head injury (32 cases -33.7%) and bone fracture (29ca-ses -30.5%). In 24cases (25.3%) all the mentioned injuries appeared simultaneously. Diagnosis was based on physical evaluation and ultrasound examination. In selected cases computed tomography was done. As the result of performed evaluation the diagnosis was made and 53 patients (55.8%) were operated. In 18 patients splenectomy was performed because of its rupture, the following 14 patients required suture of the intestine, 13 patients required drainage of intraperitoneal haematomas and ruptured mesocolon. 8 patients had injury to the liver and kidney . 42 patients ( 44.2%) were treated conservatively. Results. All of the operated patients survived and were discharged home. There were 8 deaths (8.4%) in the group treated conservatively. Six of them appeared just after the admission to the clinic or in the emergency room and two of them in the fist several days of patients stay. The reason of all the deaths was profound posttraumatic shock due to multi-organ injury. Conclusions. 1. Intraperitoneal hemorrhage and peritonitis due to gastrointestinal tract injury are the most frequent indications for surgery in patients with abdominal trauma. 2. The main reasons for unsuccessful treatment of isolated abdominal injuries are multi-organ injury and postraumatic shock.

show abstract

“…[1] Dealing with penetrating abdominal stab wounds has remained under debate. Traditionally, concern of delayed diagnosis of intra-abdominal injuries has led many trauma centers to propose mandatory abdominal exploration when a penetrating stab wound into the abdominal cavity was suspected.…”

Section: Resultsmentioning

confidence: 99%

Diagnostic peritoneal lavage in hemodynamically stable patients with lower chest or anterior abdominal stab wounds

Hashemzadeh¹,

Mameghani²,

Fouladi³

et al. 2012

Ulus Travma Acil Cerrahi Derg

View full text Add to dashboard Cite

AMAÇTorakoabdominal bıçak yaralanmaları bulunan ve hemodinamik açıdan stabil olan hastaların tedavisi halen tartış-malıdır. Bu çalışmada, bu tip hastalardaki tanısal peritoneal lavaj (TPL) sıvısındaki eritrosit sayısındaki optimal değer tartışıldı. GEREÇ VE YÖNTEMHemodinamik yönden stabil ve torakoabdominal bıçak yaralanması olan 388 hasta çalışmaya alındı. Laparotomi yö-nünden açık bir endikasyona sahip olmayan olgularda, peritoneal kavite 1000 cc serum fizyolojikle yıkandı ve akın-tı sıvısındaki eritrosit sayısı analiz edildi. Karın yaralarında >100,000/mm 3 ve alt göğüs yaralarında >10,000/mm 3 seviyesinde eritrosit sayısı eksploratuvar laparotomi (konvansiyonel yaklaşım) için endikasyonlar olarak kabul edildi. Geriye dönük yapılan analizde, eritrosit sayısı için yeni eşik değerler hesaplandı. BULGULARKonvansiyonel yaklaşımın duyarlılığı ve özgüllüğü, sıra-sıyla %90 ve %84 olmuştur. Karın yaralarında >15,000/ mm 3 ve alt göğüs yaralarında >25,000/mm 3 seviyesindeki eritrosit sayısı, operasyon gereksinimi olan veya olmayan hastaların ayırt edilmesinde, sırasıyla %94 ve %96'lık bir duyarlılık ve özgüllük ile en uygun eşik değeri bulundu. SONUÇTanısal peritoneal lavaj sıvısında eritrosit sayısı ile ilgili yeni eşik değer, torakoabdominal bıçak yaralanmaları bulunan ve hiçbir açık operasyon endikasyonu bulunmayan TPL hastalarının tedavisine kullanılabilir.

show abstract

The efficacy of serial physical examination in penetrating abdominal trauma

Cited by 53 publications

References 28 publications

Penetrating abdominal injuries in adults seen at two teaching hospitals in Ghana

Penetrating abdominal injuries in adults seen at two teaching hospitals in Ghana

Abdominal Injury. Pathogeniesis and Outcome of the Treatment

Diagnostic peritoneal lavage in hemodynamically stable patients with lower chest or anterior abdominal stab wounds

Contact Info

Product

Resources

About