• Injury · Jan 2019

    Comparative Study

    Abdominal vascular injuries: Blunt vs. penetrating.

    • Supparerk Prichayudh, Pattanapong Rassamee, Suvit Sriussadaporn, Rattaplee Pak-Art, Sukanya Sriussadaporn, Kritaya Kritayakirana, Pasurachate Samorn, Natawat Narueponjirakul, and Apinan Uthaipaisanwong.
    • Chulalongkorn University, Surgery, Rama4 rd, Bangkok, Thailand. Electronic address: Supparerk.P@Chula.ac.th.
    • Injury. 2019 Jan 1; 50 (1): 137-141.

    IntroductionAbdominal vascular injuries (AVIs) remain a great challenge since they are associated with significant mortality. Penetrating injury is the most common cause of AVIs; however, some AVI series had more blunt injuries. There is little information regarding differences between penetrating and blunt AVIs. The objective of the present study was to identify the differences between these two mechanisms in civilian AVI patients in terms of patient's characteristics, injury details, and outcomes.MethodFrom January 2007 to January 2016, we retrospectively collected the data of AVI patients at King Chulalongkorn Memorial hospital, including demographic data, details of injury, the operative managements, and outcomes in terms of morbidity and mortality. The comparison of the data between blunt and penetrating AVI patients was performed.ResultsThere were 55 AVI patients (28 blunt and 27 penetrating). Majority (78%) of the patients in both groups were in shock on arrival. Blunt AVI patients had significantly higher injury severity score (mean(SD) ISS, 36(20) vs. 25(9), p = 0.019) and more internal iliac artery injuries (8 vs. 1, p = 0.028). On the other hand, penetrating AVI patients had more aortic injuries (5 vs. 0, p = 0.046), and inferior vena cava injuries (7 vs. 0, p = 0.009). Damage control surgery (DCS) was performed in 45 patients (82%), 25 in blunt and 20 in penetrating. The overall mortality rate was 40% (50% in blunt vs. 30% in penetrating, p = 0.205).ConclusionsBlunt AVI patients had higher ISS and more internal iliac artery injuries, while penetrating AVI patients had more aortic injuries and vena cava injuries. Majority of AVI patients in both groups presented with shock and required DCS.Copyright © 2018 Elsevier Ltd. All rights reserved.

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