Khirurgiia
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Case Reports Comparative Study
[Laparocentesis and laparoscopy in the diagnosis of abdominal injuries in patients with combined trauma].
Experience in laparocentesis (152 cases) and laparoscopy (40 cases) in persons with concurrent trauma is discussed. Laparocentesis with lavage of the abdominal cavity is the method of choice in such patients because it ensures correct diagnosis in 98% of cases and does not distort the clinical picture on the abdomen during the subsequent surveillance.
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Concomitant injury to the large vessels and other abdominal organs are related to the category of severe injuries with high postoperative mortality rates. The authors discuss 21 patients with the trauma, 9 of them with injury to the inferior vena cava. Early operation, adequate compensation for the blood loss, and co-operation with angiosurgeons will improve the number of favourable outcomes.
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Among 2,778 patients with mechanical injury, 361 (13.3%) had closed abdominal trauma. The authors distinguish two syndromes in the clinical picture: developing peritonitis and intraabdominal blood loss. Laparocentesis is conducted if injury to the viscera is suspected; the authenticity of the intervention comes up to 97.9-100%. Ultrasonic examination may be undertaken if hemodynamics are stable before laparocentesis.
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The article analyses the results of treatment of gunshot injuries to the chest and abdomen suffered by 59 males in peace time. Their ages ranged from 17 to 51 years. It was found that gunshot injuries to the chest and abdomen suffered in peace time are characterized by a severe clinical course, multiple damages of polyorganic localization, they are often attended by shock and are marked by a great number of pyoseptic complications and a high mortality rate, particularly in concurrent and combined injuries to the organs of both cavities.