Southern medical journal
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Retroperitoneal injury caused by penetrating trauma or associated with progressive shock following blunt trauma is usually recognized promptly and managed appropriately. Isolated retroperitoneal injury from blunt trauma, unless accompanied by major hemorrhage or gross hematuria, is often difficult to diagnose and needed treatment may be delayed. Although clinical examination remains the cornerstone of diagnosis, the high incidence of ethanol abuse and/or concurrent head injury in trauma patients has led to increased use of computed tomography in the diagnosis of abdominal trauma. ⋯ There were 90 pelvic fractures and 31 lumbar spine fractures, as well as 21 genitourinary, 12 gastrointestinal, five pancreatic, and eight major vascular injuries. Ten patients had isolated retroperitoneal hematomas. We conclude that (1) patients with retroperitoneal injuries and coexisting intraperitoneal injuries should have early operation; (2) isolated retroperitoneal trauma tends to lead to observation unless CT is used as part of the early assessment; and (3) routine use of CT in patients at risk accurately defines the extent of injury and enhances clinical management.
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Southern medical journal · Sep 1987
Biography Historical ArticleHenry Hill Hickman (1800-1830): country doctor and discoverer of inhalation anesthesia.