Eur J Trauma Emerg S
-
Eur J Trauma Emerg S · Jun 2008
Secondary Abdominal Compartment Syndrome in a Patientwith Isolated Extraperitoneal Injuries.
The abdominal compartment syndrome (ACS) is defined as increased intra-abdominal pressure (IAP) associated with adverse physiologic consequences. The ACS ismost commonly diagnosed in patients sustaining abdominal or pelvic trauma, or suffering some other intraabdominal hemorrhagic catastrophe. Recently, several groups have reported cases in which patients sustaining extra-abdominal trauma developed ACS following acute resuscitation with crystalloids or blood. ⋯ SACS is a poorly understood and characterized syndrome where the increased intra-abdominal pressure occurs without abdominal injury. Timely diagnosis is difficult because of its low incidence and major trauma to other body regions. We report a fatal case of SACS, which progressed to necrotic and gangrenous large bowel.
-
Blunt thoracic trauma resulting in lung contusion with severe diffuse pulmonary hemorrhage and massive hemoptysis is rare and has a poor prognosis. Treatment options are limited. We report a case of the successful use of recombinant activated factor VII (NovoSeven™) in the treatment of life-threatening diffuse pulmonary hemorrhage secondary to an isolated blunt force thoracic injury without relevant traumatic coagulopathy.
-
Eur J Trauma Emerg S · Jun 2008
Delayed Presentations of Blunt Mesenteric and Intestinal Trauma in the Wake of Injury.
To analyze the presentation and timing of blunt mesenteric and intestinal trauma requiring surgical intervention. ⋯ Acceleration-deceleration abdominal injury affects the terminal ileum more commonly. We propose that the ensuing clinical picture depends on the level of energy transmitted: high-energy trauma leads to extensive mesenteric and bowel tears and is diagnosed immediately. Low-energy trauma may lead to chronic ischemia, fibrosis and stricture-formation. The right colon appears to be more vulnerable to lowflow states following blunt trauma.
-
Nonoperative management is being increasingly employed in the management of blunt hepatic injuries. ⋯ Complex liver injuries can be managed successfully with conservative treatment in majority, with low mortality and acceptable morbidity. Surgery is reserved for selected indications.