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Citation
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Parreira JG, Oliari CB, Malpaga JM, Perlingeiro JA, Soldá SC, Assef JC. Injury 2015; 47(1): 89-93. |
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Affiliation
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Department of Surgery, Santa Casa de Sao Paulo School of Medical Sciences, Emergency Service, Irmandade da Santa Casa de São Paulo, São Paulo, Brazil. |
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Abstract
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BACKGROUND: to assess the severity and treatment of "occult" intra-abdominal injuries in blunt trauma victims.
METHOD: Retrospective analysis of charts and trauma register data of adult blunt trauma victims, admitted without abdominal pain or alterations in the abdominal physical examination, but were subsequently diagnosed with intra-abdominal injuries, in a period of 2 years. The severity was stratified according to RTS, AIS, OIS and ISS. The specific treatment for abdominal injuries and the complications related to them were assessed.
RESULTS: Intra-abdominal injuries were diagnosed in 220 (3.8%) out of the 5785 blunt trauma victims and 76 (34.5%) met the inclusion criteria. The RTS and ISS median (lower quartile, upper quartile) were 7.84 (6.05, 7.84) and 25 (16, 34). Sixty seven percent had a GCS≥13 on admission. Injuries were identified in the spleen (34), liver (33), kidneys (9), intestines (4), diaphragm (3), bladder (3) and iliac vessels (1). Abdominal injuries scored AIS≥3 in 67% of patients. Twenty-one patients (28%) underwent laparotomy, 5 of which were nontherapeutic. The surgical procedures performed were splenectomy (8), suturing of the diaphragm (3), intestines (3), bladder (2), kidneys (1), enterectomy/anastomosis (1), ligation of the common iliac vein (1), and revascularization of the common iliac artery (1). Angiography and embolization of liver and/or spleen injuries were performed in 3 cases. Three patients developed abdominal complications, all of which were operatively treated. There were no deaths directly related to the abdominal injuries.
CONCLUSION: Severe "occult" intra-abdominal injuries, requiring specific treatment, may be present in adult blunt trauma patients.
Language: en |