Keywords : abdominal trauma


Relaparotomies in Abdominal Trauma, Systematic Review

Haider Abdulhussein Ahmed; Sajid Hameed Abd Al-Helfy

Iraqi Postgraduate Medical Journal, 2015, Volume 14, Issue 1, Pages 123-130

ABSTRACT:
BACKGROUND:
Treatment of a number of complications that occur after abdominal trauma surgeries may require that Urgent Abdominal Re-explorations, the life-saving and obligatory operations, are performed.
OBJECTIVE:
To evaluate the reasons and incidence of re-operations in abdominal trauma cases and their outcomes in our centre, so that more preventable morbidity can be avoided.
METHODOLOGY:
A retrospective study of all trauma victims who sustained laparatomies and relaparatomies in the Emergency Department of Al-Imamain Al-kadhymain Medical City, Baghdad, over a 2 years period. A review of the case sheets of these victims has been reviewed to identify the various circumstances of trauma cases and the detailed operative findings and definitive causes of relaparatomies were noted.
RESULTS:
The study included 21 relaparatomy cases out of 244 laparatomy for various abdominal trauma reasons ; 180 patients (74%) males and 64 (26%) females, with a male to female ratio of about (3:1). The commonest causative accidents were missile inury 97pt (39%), gunshot injuries 58 (24%), road traffic accidents 43pt (18%), stab wound 32 pt(13%), and. Fall from height 14 pts (6%) . Reoperations were performed in 21 cases Incidence (8.6%), finding in reoperation including second look operation (which constituted 4 patients) were as the followings:
Bleeding 11 pts ( 52%), peritonitis from missed bowel injuries & anastomosis leak 5 pts (24% ), small bowel obstruction one pt (5%), IAC(abscess) 2pt (9.5%) and prolonged ileus & peritonism 2 Pts (9.5%).
Overall mortality in the reexplored patients was 8 patients(38%). Incidence of missed injuries 24% of reoperation and 1.6% of total trauma cases.
CONCLUSION:
many pt can be saved from repeat laparatomy by avoiding missed injuries. The main reason for immediate reoperation is bleeding and lately is peritonitis and sepsis.

Evaluation of Focused Abdominal Sonography for Trauma (FAST) in Baghdad Teaching Hospital

Raed J .Wiwit; Saad Abdulla Ibrahim Sarsam; Salah M.Tajer

Iraqi Postgraduate Medical Journal, 2009, Volume 8, Issue 4, Pages 393-397

ABSTRACT:
BACKGROUND:
Focused Abdominal Sonography for Trauma (FAST) is widely applied in the initial management of trauma patients, Being non invasive, repeatable and without risk of irradiation, make it attractive tool in evaluation of trauma patients.
OBJECTIVE:
Evaluation FAST sensitivity and specificity in detection of hemoperitoneum in abdominal trauma victims .
METHODS:
Prospective study conducted in the emergency department of Baghdad teaching hospital for one year period .The FAST done by a general surgeon or emergency physician during the secondary survey of blunt and penetrating abdominal trauma victims with equivocal clinical findings.
RESULTS:
Ninety three (93) patients included in the study, with over all sensitivity of FAST was 80.9 % and specificity 95.8 %. In blunt abdominal trauma the sensitivity was 92.3 % and specificity was 96 % while in penetrating abdominal trauma the sensitivity was only 62.5 % and specificity 95.2 %.
CONCLUSION:
FAST is highly sensitive and specific in detection of hemoperitoneum after blunt abdominal trauma ,but its lower sensitivity in penetrating abdominal injury require modification in the protocols like repetition of the scan or application of extra views. Its high specificity make it suitable as "rule in" test in both blunt and penetrating abdominal injury.