Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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Children with pelvic fractures usually are polytraumatized. Concomitant abdominal and pelvic injuries are not uncommon. Medical records and X-rays of 54 children, in which a pelvic fracture was diagnosed at our institution from 1974-1993, were reviewed. ⋯ There were 7 liver lacerations, 7 splenic injuries, 2 mesenteric tears, 2 kidney injuries and 1 small bowel lesion. Eight children (14.8%) died with 5 of them due to retroperitoneal or/and abdominal bleeding complications. A recent follow-up examination (81.8%) with a mean follow-up of 11.3 years showed that long-term morbidity usually was attributed to pelvic concomitant injuries.
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This report describes a retrospective study concerning 314 patients suffering from acute abdominal pain admitted to the surgical emergency unit of Zürich University Hospital in 1992. Basic diagnostic work-up (history, physical examination, blood tests, sonography and abdominal X-ray) revealed the final diagnosis in 188 patients. Sonography was essential in 77 cases. ⋯ A follow-up examination of these patients 6-18 months later resulted in a final diagnosis of somatic diseases in 8% of cases. This study demonstrated that the basic surgical diagnostics are efficient and reveal the final diagnosis with minimal delay. Abdominal sonography is the most important diagnostic tool in this context and should, therefore, be mastered and employed by the surgeon himself.