The American surgeon
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The charts of 124 consecutive patients with extremity shotgun injuries managed over an 8-year period were reviewed to assess the results of a uniform protocol. This consisted of liberal use of arteriography, prompt exploration, wide debridement or fasciotomy, and frequent operating room dressing changes for large wounds. Thirty-three patients had arterial injuries and 16 had major venous injuries. ⋯ Of the six limb amputations, three were done primarily and three were performed for late septic complications. Two of these late amputations were done following inadequate initial revascularization at referring hospitals. Early wound closure, liberal use of arteriography and fasciotomy, early fracture stabilization, and repair of all significant vascular injuries contribute to a successful outcome in patients with extremity shotgun wounds.
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This study was undertaken to review our operative experience in the management of pediatric renal trauma. Over a 2-year period (August 1988 to August 1990) 25 of 60 children undergoing celiotomy sustained renal injuries. There were 22 boys and three girls ranging in age from 5 to 18 years. ⋯ There is a high incidence of associated intra-abdominal injury in those who have sustained penetrating renal trauma, but mortality is more common in patients sustaining associated thoracic and vascular injuries. An IVP should be performed, even in the absence of hematuria, when trauma trajectory strongly suggests urologic injury. This study also illustrates the sharp rise in drug-related urban violence with an associated increase in pediatric renal trauma.
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The American surgeon · Jun 1993
Case ReportsAn unusual injury of the sigmoid colon produced by seat belt trauma.
It is well documented that use of seat belts will reduce the incidence and severity of injuries associated with motor vehicle accidents. However, seat belts themselves can produce serious injury, particularly if worn incorrectly. Three cases of an unusual sigmoid colon injury produced by seat belt trauma are reported. Each patients physical exam findings, as well as the anatomy and histology of the injury, are presented to illustrate the deceptive nature of this injury, and to stress the importance of an accurate diagnosis and management.