SURGICAL SYMPOSIUM CONTRIBUTION Management Guidelines for Penetrating Abdominal Trauma

نویسندگان

  • Walter L. Biffl
  • Ari Leppaniemi
چکیده

Introduction The optimal management of patients with penetrating abdominal injuries has been debated for decades, since mandatory laparotomy (LAP) gave way to the concept of ‘‘selective conservatism.’’ Materials and Methods A comprehensive literature review was performed and summarized. Results A proposed management guideline for patients with penetrating abdominal trauma was created. Conclusion Indications for immediate laparotomy (LAP) include hemodynamic instability, evisceration, peritonitis, or impalement. Selective nonoperative management of stable, asymptomatic patients has been demonstrated to be safe. Adjunctive diagnostic testing—ultrasonography, computed tomography, local wound exploration, diagnostic peritoneal lavage, laparoscopy—is often used in an attempt to identify significant injuries requiring operative management. However, prospective studies indicate that these tests frequently lead to nontherapeutic LAP, and are not cost-effective.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Practice management guidelines for selective nonoperative management of penetrating abdominal trauma.

BACKGROUND : Although there is no debate that patients with peritonitis or hemodynamic instability should undergo urgent laparotomy after penetrating injury to the abdomen, it is also clear that certain stable patients without peritonitis may be managed without operation. The practice of deciding which patients may not need surgery after penetrating abdominal wounds has been termed selective ma...

متن کامل

گزارش موردی: جراحت ورید اجوف تحتانی در مرد جوان 18 ساله با آسیب نافذ شکمی

Abstract: In penetrating abdominal trauma, injury to the inferior vena cava is rare but continues to pose a taxing problem for the trauma surgeon. Despite the improved preoperative care and surgical skills, mortality rates for IVC injuries are still high. The most important factors, which play a significant role in mortality, are presence of shock on admission, the anatomical level of vena cava...

متن کامل

The role of laparoscopy in abdominal trauma – review of the literature

The necessity of urgent explorative laparotomy as a standard procedure in the treatment of abdominal penetrating wounds is controversial. Mandatory surgical intervention for penetrating abdominal trauma yields a high rate of negative laparotomies in the absence of visceral injuries. Laparoscopy is an alternative diagnostic procedure inspecting the peritoneum for signs of perforation and excludi...

متن کامل

C Management guidelines for pen etrating abdominal trauma

Current Opinion in Critical Care 2010, 16:609–617 Purpose of review Patients with penetrating abdominal trauma are at risk of harboring life-threatening injuries. Many patients are in need of emergent operative intervention. However, there are clearly patients who can be safely managed nonoperatively. This review evaluates the literature to identify management guidelines for patients with penet...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:

دوره   شماره 

صفحات  -

تاریخ انتشار 2014