By Harry M. Delany M.D., F.A.C.S., Robert S. Jason M.D. (auth.)
Trauma to the stomach, either unintentional and willful, has develop into more and more universal during this period of accelerating violence. huge numbers of sufferers everywhere in the kingdom are admitted to emergency rooms due to stomach trauma of various levels of severity. All too usually the proper analysis is suspected belatedly or in no way, in order that right remedy isn't initiated in adequate time to be lifesaving. now not infre quently, the injured sufferer is tested by means of an intern or an insufficiently skilled resident medical professional. Even in cases the place extra senior internists and surgeons can be found, exact wisdom concerning the valuable method to set up the right kind analysis and institute the suitable therapy is missing. This monograph, representing the felicitous collaboration of a doctor and a radiolo gist including numerous different participants, is well timed and critical. The authors (and their members) have approached their topic with a wealth of medical experi ence got in different very energetic acute-care municipal hospitals within the biggest urban during this nation. they've got saw and handled a really huge variety of sufferers with a large number of irritating factors, together with firearm accidents, stab wounds, vehicular injuries, falls, and attacks. The authors have divided this paintings into 4 major sections: basic views on stomach damage, sorts of belly accidents, particular Diagnostic recommendations, and particular Organ or Supporting-Structure Injury.
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Additional resources for Abdominal Trauma: Surgical and Radiologic Diagnosis
Surgery 59: 650-653 38. Shaftan GW (1960) Indications for operation in abdominal trauma. Am J Surg 99: 657-664 39. Shaftan GW (1969) Editorial: Selective conservatism in penetrating abdominal trauma. J Trauma 9(12): 10261028 40. Sims JM (1882) The treatment of gunshot wounds of the abdomen in relation to modern peritoneal surgery. Br Med J 302 41. Snyder CJ (1972) Bowel injuries from automobile seat belts. Am J Surg 123: 312-316 42. Steichen FM, Efron G, Pearlman OM, Weil PH (1969) Radiographic diagnosis versus selective management in penetrating wounds of the abdomen.
However, the examining physician should also make his own initial confirmatory determination. The General Examination The patient's general appearance in the emergency room may reflect the severity of an intraabdorninal injury. An unconscious or virtually lifeless patient who presents with an isolated abdominal injury probably has sustained massive blood loss. The possibility of blunt head injury or drug overdose must also be considered. The level of consciousness is not usually impaired by an isolated abdominal injury, and the patient usually will relate the site and character of the pain and the source of injury.
The balance of patients may have a rupture up to 150 days following injury. The criterion for a diagnosis of delayed splenic rupture consists of a pe- riod of at least 36 to 48 h before the appearance of signs of intraperitoneal hemorrhage. Recently, doubt has been expressed whether time "delay" in rupture of the spleen does occur or whether the problem is really a delay in diagnosis [8,84]. A history of trauma is therefore quite important in the evaluation of the patient's condition. Despite the fact the trauma may seem quite incidental in the history of a patient's previous medical problems, there are a number of conditions that relate to previous blunt or penetrating injuries.