The Surgical clinics of North America
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Abdominal vascular injuries remain rare in centers that primarily treat victims of blunt trauma, but when penetrating wounds of the abdomen are commonly treated, the incidence of abdominal vascular injuries is surprisingly high. With suitable management, many of these patients survive.
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Thoracic great vessel injury may be secondary to blunt, penetrating, blast, or iatrogenic trauma. A surgeon should be the initial evaluator of and decision maker for these patients, and the aortogram remains the gold standard for specific diagnosis of the arterial injuries except in those patients requiring emergency thoracotomy. Two general types of incisions are employed for these injuries: resuscitative and elective.
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Hemorrhage accounts for 90 per cent of deaths after abdominal injury, and half of these deaths are secondary to a recalcitrant coagulopathy. This review concentrates on our present knowledge of the role of hypothermia in trauma-related coagulopathies and notes that preventing as well as treating these disorders remains the focus and the challenge of many investigators in the field of trauma.