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Blunt abdominal trauma in children. Actualizads review will examine the current evidence regarding pediatric blunt abdominal trauma and the physical exam findings, laboratory actualizwda, and radiographic imaging associated with the diagnosis of intra- abdominal injuries IAIas well as review the current literature on pediatric hollow viscus injuries and emergency department disposition after diagnosis.
The importance of the seat belt sign on physical examination and screening laboratory data remains controversial, although screening hepatic enzymes are recommended in the evaluation of nonaccidental trauma to identify occult abdominal organ injuries.
Patients with concern for undiagnosed IAI, including bowel injury, may be considered for hospital admission and serial abdominal exams without an increased risk of complications, if an exploratory laparotomy is not performed emergently.
Although the FAST exam is not recommended as the sole screening tool to rule out IAI in aactualizada stable trauma patients, it may be used in conjunction with the physical exam and laboratory findings to identify children at risk for IAI.
Emergency Preparedness, Response and Recovery | Public | Clemson University, South Carolina
Children with a normal physical exam and normal abdominal Acualizada may not require routine hospitalization after blunt abdominal trauma. Appendicitis following blunt abdominal trauma. Appendicitis is a frequently encountered surgical problem in the Emergency Department ED. Appendicitis typically results from obstruction of the appendiceal lumen, although trauma has been reported as an infrequent cause of acute appendicitis.
Intestinal injury and hollow viscus injury following blunt abdominal trauma are well reported in the literature but traumatic appendicitis is much less common.
The pathophysiology is uncertain but likely sctualizada from several mechanisms, either in isolation or combination. Evaluation for traumatic appendicitis requires a careful history and physical exam.
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Imaging with ultrasound or computed tomography is recommended if the history and physical do not reveal an acute surgical indication. Treatment includes intravenous antibiotics and surgical consultation for appendectomy. This case highlights a patient who developed acute appendicitis following blunt trauma to the abdomen sustained during a motor vehicle accident. Appendicitis must be considered as part of the differential diagnosis in any patient who presents to the ED with abdominal pain, including those whose pain begins after sustaining blunt trauma to the abdomen.
Because appendicitis following trauma is uncommon, timely diagnosis requires a high index of suspicion. Hernia Following Blunt Abdominal Trauma.
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Full Text Available Traumatic abdominal wall actualizzada is a rare type of hernia, which follows blunt trauma to the abdomen, where disruption of the musculature and fascia occurs with the overlying skin remaining intact. Diagnosis of this problem is very difficult and delayed.
Traumatic hernia is often diagnosed during laparatomy or laparascopy, but CT scan also has a role in distinguishing this pathology. Delay in diagnosis is very dangerous and can result in gangrene and necrosis of the organs in the hernia. The case report of a 35 years old man with liftruck blunt trauma is reported. His vital signs were stable. On physical examination, tenderness of RUQ was seen. He underwent Dpl for suspected hemoprotein.
Dpl was followed up by laparatomy. Laparatomy revealed that the transverse and ascending colon partially herniated in the abdominal wall defect. The colon was reduced in the abdomen and repair of abdominal hernia was done.
The patient was discharged after 5 day. The etiology, pathogenesis and management are discussed. Acute appendicitis after blunt loh trauma. Full Text Available Appendecitis is one of the most frequent surgeries.
In this study we presented an uncommon type atcualizada appendicitis which occurred after abdominal blunt trauma. In this article three children present who involved actualisada appendicitis after blunt abdominal trauma. These patients were 2 boys 5 and 6-year-old and one girl 8-year-old who after blunt abdominal trauma admitted to the hospital with abdominal actualizdaa and symptoms of acute abdomen and appendectomy had been done for them.
Trauma can induce intramural hematoma at appendix process and may cause appendicitis. Therefore, physicians should be aware of appendicitis after blunt abdominal trauma.
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Roentgenologic evaluation of blunt abdominal trauma. This study comprises 25 cases of blunt abdominal trauma proved by surgery. It is concluded that visceral damage by blunt abdominal trauma may be suspected, but can not be satisfactorily diagnosed upon a single plane abdominal roentgenologic examination with clinical support.
Contrary to some reports in the literature, rupture of the hallow, viscus is more susceptible than solid organ and ileum is more than jejunum. It is a useful roentgenologic sign denoting distension and small cresent air shadow in the duodenal sweep of the damaged pancreas. Isolated jejunal perforation following blunt abdominal trauma. Full Text Available Isolated perforation of the jejunum, following blunt abdominaltrauma, is extremely rare.
These injuries aredifficult to diagnose because initial clinical signs are frequentlynonspecific and a delay in treatment increasesmortality and morbidity of the patients. Conventional radiogramsare often actualizzda for diagnosing this subsetof trauma.
For actualiizada accurate and timely diagnosis, qctualizada of bowel perforation and the need for repeatedexaminations should be kept in mind. Herein, we presenta year-old man with isolated jejunal perforation followingblunt abdominal trauma.
Blunt abdominal traumaisolated jejunal perforation,early diagnosis. The aim of the study is to study incidence, demographic profile, epidemiological factors, mechanism of traumatreatment modalities, associated injuries, postoperative complications and morbidity and mortality. Demographic data, mechanism of traumamanagement and outcome were studied. Spleen was the commonest organ involved and most common procedure performed was splenectomy.
Most common extra- abdominal injury was rib fractures. Wound infection was the commonest complication. FAST is more useful in blunt abdominal trauma patients who are unstable. CT abdomen is more useful in stable patients. Definitive indication for laparotomy was haemodynamic instability and peritonitis.
Associated injuries influenced morbidity and mortality. Early diagnosis and prompt treatment can save many lives. Predictors of abdominal injuries in blunt trauma. To identify predictors of abdominal injuries in victims of blunt trauma.
Student’s t, Fisher and qui-square tests were used for statistical analysis, considering p3 in head The highest odds ratios for the diagnosis of abdominal injuries were associated flail chest Abdominal injuries were more frequently observed in patients with hemodynamic instability, changes in Glasgow coma scale and severe lesions to the head, chest and extremities.
Base deficit, Blunt abdominal trauma. Gastrointestinal Injuries in Blunt Abdominal Traumas. Patients with gastrointestinal injuries due to blunt trauma operated within the last six years have been studied retrospectively in terms of demographics,injury mechanism and localization, additional injuries, RTS and ISS, operative technique, morbidity, mortality and duration lpu hospitalization.
Of the eighteen cases, cause of injury was a traffic accident for 11 Among the eighteen patients,there were 21 gastrointestinal injuries 11 intestinal, 6 colon,3 acttualizada, 1 stomach. Primary suture 10segmentary resection 9 and pyloric exclusion 2 were the operations performed for the twenty-one gastrointestinal injuries.
Although statistically not significant, 13 Comparing acgualizada RTS 7. High ISS is significantly related to the risk of both. With the inventions of faster cars and even more actualizaea motorbikes there is a worldwide increase in road traffic accidents, which has increased the incidence of blunt abdominal trauma but still duodenal injury following a blunt abdominal trauma is uncommon and can pose a formidable challenge to the surgeon and failure to manage it properly can result in devastating results.
It may typically occur in isolation or with pancreatic injury. Here, we report a case of an isolated transection of the Multidetector CT findings of bowel Transection in blunt abdominal trauma. Though a number of CT findings of bowel and mesenteric injuries in blunt abdominal trauma are described in literature, no studies on the specific CT signs of a transected bowel have been published.
In the present study we describe the incidence and new CT signs of bowel transection in blunt abdominal trauma. We investigated the incidence of bowel transection in patients admitted for blunt abdominal trauma who underwent multidetector CT MDCT. The MDCT findings of 8 patients with a surgically proven complete bowel transection were assessed retrospectively. We report novel CT signs that are unique for transection, such as complete cutoff sign transection of bowel loopJanus sign abnormal dual bowel wall enhancement, both increased and decreased lpb, and fecal spillage.
The incidence of bowel transection in blunt abdominal trauma was 1. In eight cases of bowel transection, percentage of CT signs unique for bowel transection were as follows: The combination of complete cutoff and Janus sign were highly specific findings in patients with bowel transection. Complete cut off and Janus sign are the unique CT findings to help detect bowel transection in blunt abdominal trauma and recognition of these findings enables actualizadw accurate and prompt diagnosis for emergency laparotomy leading to reduced mortality and morbidity.
Blunt injury trauma is regularly encountered in the emergency department. Diagnostic tools that help in optimum management of blunt abdominal trauma include; Focussed Assessment Sonography for Trauma scan, Diagnostic peritoneal lavage and Computed Tomography scan. The aim of this study is to determine the validity of CT scan as an accurate diagnostic tool and its role in management of patients with blunt abdominal trauma.
A prospective analysis of 80 patients of blunt abdomen trauma who were admitted in Manipal Teaching Hospital, Pokhara, Nepal within a span of 15 months was done. Demographic data, mechanism of traumamanagement and outcomes were studied.
Organ injuries were graded using actuallzada Organ Injury Scale guidelines. Most of the patients in our study were in the age group of years with an M: F ratio of 2. Road traffic accident FAST scan had sensitivity of In conjunction with close clinical monitoring, CT scan is reliable in the evaluation and management of blunt abdominal trauma patients.