Pancreatic injuries can result in significant morbidity and mortality if missed or unnoticed and also pose a great challenge in terms of diagnosis and treatment. We present a case of an 11 year old boy presenting with...Pancreatic injuries can result in significant morbidity and mortality if missed or unnoticed and also pose a great challenge in terms of diagnosis and treatment. We present a case of an 11 year old boy presenting with history of blunt trauma abdomen following handle bar injury. He had signs of abdominal distension and CECT of the abdomen showed transection of the pancreas in the region of junction between the body and tail. On exploratory laparotomy there was rupture at junction of body and tail of pancreas with intact pancreatic duct and a spleen preserving distal pancreatectomy was performed. In the presence of an intact pancreatic duct conservative management should be offered however this patient underwent spleen preserving distal pancreatectomy because of pancreatitis and necrosis ensuing in the pancreatic remnant margin. Hence, complete transection does not necessarily mean loss of ductal integrity and decision to preserve or remove the distal pancreas should not be based merely on ductal integrity but probably other factors also i.e. pancreatitis and necrosis.展开更多
<b><span>Background:</span></b><span> Blunt thoracic and abdominal traumas are frequent and have a poor prognosis in the absence of prompt diagnosis and adequate management. An ultra...<b><span>Background:</span></b><span> Blunt thoracic and abdominal traumas are frequent and have a poor prognosis in the absence of prompt diagnosis and adequate management. An ultrasound performed in the emergency room allows a precise diagnosis and a better orientation of the victims.</span><span> </span><b><span>Objective:</span></b><span> To assess the contribution of EFAST ultrasound in the management of blunt thoracic and abdominal traumas.</span><span> </span><b><span>Patients and method:</span></b><span> Cross-sectional descriptive and analytical study with prospective data collection carried out from February 20</span><sup><span style="vertical-align:super;">th</span></sup><span> to August 20</span><sup><span style="vertical-align:super;">th</span></sup><span>, 2017 in the emergency and intensive care units of the Parakou University Hospital Centre. An ultrasound machine fitted with a 3.5 MHz convex probe was used to search for post-traumatic effusion by the EFAST technique on admission and then as needed over 24 hours and after surgery.</span><span> </span><b><span>Results:</span></b><span> Sixty-three patients were collected with an 85.71% male predominance. The average age was 31.36 ± 13.29 years. The time to perform the EFAST ultrasound was 7 ± 3 min. EFAST was positive in 50.79% of patients. Five patients (7.93%) received emergency treatment for hemodynamic instability and positive EFAST within an average of 3.46 ± 2 hours. Eighteen patients (27.58%) received after monitoring by EFAST, surgery within 9 hours 12 minutes (hemoperitoneum) and 27 hours 58 minutes (hemothorax). Two patients were tested positive</span><span>ly</span><span> for EFAST after surgery.</span><span> </span><b><span>Conclusion:</span></b><span> The introduction of an EFAST ultrasound as a sorting tool in an environment with limited resources is desirable and feasible.</span>展开更多
We undertook a prospective and descriptive observational study on abdominal trauma from February 1, 2016 to August 31, 2017. The aim of this work was to identify the typology and management of abdominal trauma cases i...We undertook a prospective and descriptive observational study on abdominal trauma from February 1, 2016 to August 31, 2017. The aim of this work was to identify the typology and management of abdominal trauma cases in our surgery department. Overall, abdominal trauma represented 3.54% (62/1751) of all surgeries during the study period. Among the 62 cases, men accounted for 59 and women for 3. The sex ratio was 19.67. The mean age was 24 ± 15 years. Road accidents were the most represented with 43.5% of cases. The couple of signs, hypovolemic shock and abdominal pain and decrease on blood pressure were the prominent clinical symptoms with 100.0%, and 50.0% of cases, respectively. Abdominal ultrasound and abdominal x-ray without contrast were performed in 67.0% and 18.0% of cases, respectively. Abdominal trauma was divided into two entities: contusion 68% and wounds 32%. Medical treatment was sufficient in 23.00% of cases. Laparotomy as a surgical approach was performed in 77.0% of cases. Local hemostasis plus drainage (27.08%), splenectomy (25.00%), suture (14.58%), hemostasis by tamponade (8.33%) and colostomy (2.08%) were undertaken as surgical procedures when it came to deal with contusions. Debridement of wounds plus suture and hemostasis by tamponade was performed in 18.73% and 4.16 cases, respectively. The most observed lesions were those of the spleen with 27.42% and those of the small bowel with 24.19%. The postoperative follow-up was straightforward in 83.33% of cases. The overall mortality was 4.17%.展开更多
随着社会经济的快速发展、汽车的增多,交通伤等多种复杂致伤因素导致的创伤病例越来越多。近年来损伤控制性手术(damage control surgery,DCS)用于创伤治疗,提高了严重多发伤患者抢救的成功率。本文主要介绍损伤控制性手术的发展历程,...随着社会经济的快速发展、汽车的增多,交通伤等多种复杂致伤因素导致的创伤病例越来越多。近年来损伤控制性手术(damage control surgery,DCS)用于创伤治疗,提高了严重多发伤患者抢救的成功率。本文主要介绍损伤控制性手术的发展历程,阐述其临床应用及研究进展。展开更多
文摘Pancreatic injuries can result in significant morbidity and mortality if missed or unnoticed and also pose a great challenge in terms of diagnosis and treatment. We present a case of an 11 year old boy presenting with history of blunt trauma abdomen following handle bar injury. He had signs of abdominal distension and CECT of the abdomen showed transection of the pancreas in the region of junction between the body and tail. On exploratory laparotomy there was rupture at junction of body and tail of pancreas with intact pancreatic duct and a spleen preserving distal pancreatectomy was performed. In the presence of an intact pancreatic duct conservative management should be offered however this patient underwent spleen preserving distal pancreatectomy because of pancreatitis and necrosis ensuing in the pancreatic remnant margin. Hence, complete transection does not necessarily mean loss of ductal integrity and decision to preserve or remove the distal pancreas should not be based merely on ductal integrity but probably other factors also i.e. pancreatitis and necrosis.
文摘<b><span>Background:</span></b><span> Blunt thoracic and abdominal traumas are frequent and have a poor prognosis in the absence of prompt diagnosis and adequate management. An ultrasound performed in the emergency room allows a precise diagnosis and a better orientation of the victims.</span><span> </span><b><span>Objective:</span></b><span> To assess the contribution of EFAST ultrasound in the management of blunt thoracic and abdominal traumas.</span><span> </span><b><span>Patients and method:</span></b><span> Cross-sectional descriptive and analytical study with prospective data collection carried out from February 20</span><sup><span style="vertical-align:super;">th</span></sup><span> to August 20</span><sup><span style="vertical-align:super;">th</span></sup><span>, 2017 in the emergency and intensive care units of the Parakou University Hospital Centre. An ultrasound machine fitted with a 3.5 MHz convex probe was used to search for post-traumatic effusion by the EFAST technique on admission and then as needed over 24 hours and after surgery.</span><span> </span><b><span>Results:</span></b><span> Sixty-three patients were collected with an 85.71% male predominance. The average age was 31.36 ± 13.29 years. The time to perform the EFAST ultrasound was 7 ± 3 min. EFAST was positive in 50.79% of patients. Five patients (7.93%) received emergency treatment for hemodynamic instability and positive EFAST within an average of 3.46 ± 2 hours. Eighteen patients (27.58%) received after monitoring by EFAST, surgery within 9 hours 12 minutes (hemoperitoneum) and 27 hours 58 minutes (hemothorax). Two patients were tested positive</span><span>ly</span><span> for EFAST after surgery.</span><span> </span><b><span>Conclusion:</span></b><span> The introduction of an EFAST ultrasound as a sorting tool in an environment with limited resources is desirable and feasible.</span>
文摘We undertook a prospective and descriptive observational study on abdominal trauma from February 1, 2016 to August 31, 2017. The aim of this work was to identify the typology and management of abdominal trauma cases in our surgery department. Overall, abdominal trauma represented 3.54% (62/1751) of all surgeries during the study period. Among the 62 cases, men accounted for 59 and women for 3. The sex ratio was 19.67. The mean age was 24 ± 15 years. Road accidents were the most represented with 43.5% of cases. The couple of signs, hypovolemic shock and abdominal pain and decrease on blood pressure were the prominent clinical symptoms with 100.0%, and 50.0% of cases, respectively. Abdominal ultrasound and abdominal x-ray without contrast were performed in 67.0% and 18.0% of cases, respectively. Abdominal trauma was divided into two entities: contusion 68% and wounds 32%. Medical treatment was sufficient in 23.00% of cases. Laparotomy as a surgical approach was performed in 77.0% of cases. Local hemostasis plus drainage (27.08%), splenectomy (25.00%), suture (14.58%), hemostasis by tamponade (8.33%) and colostomy (2.08%) were undertaken as surgical procedures when it came to deal with contusions. Debridement of wounds plus suture and hemostasis by tamponade was performed in 18.73% and 4.16 cases, respectively. The most observed lesions were those of the spleen with 27.42% and those of the small bowel with 24.19%. The postoperative follow-up was straightforward in 83.33% of cases. The overall mortality was 4.17%.
