surgical procedures and management

Apr 15th, 2015
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ABDOMINAL INJURIESA. INTRODUCTIONTrauma or injury is the damage to the body caused by an exchange with external environmental energy that is beyond the body's resilience.Trauma is the major cause of death for all individuals of all ages.Abdominal injuries account for 10% of deaths due to trauma.These deaths results from failure to recognize and control bleeding from intra-abdominal organs.The abdomen is a diagnostic "forest".Physical examination is unreliable in determining injured intra-abdominal organ.Presence of abdominal rigidity or gross distension is an indication for prompt surgical exploration.Serial examination by the same clinician will assist in early detection of peritoneal inflammation requiring surgical intervention.B. AETIOLOGICAL CLASSIFICATIONPenetrating: a. Stab woundsb. Gunshot woundsBlunt (non-penetrating):a. Crush injuryb. Blast injuryc. Seatbelt injuryd. Acceleration/deceleration injuriesIatrogenic: a. Endoscopic proceduresb. External cardiac massagec. Peritoneal dialysisd. Paracentesise. Liver biopsyf. Barium enema, etc.C. CATEGORIES OF INJURED PATIENTSAfter initial resuscitation, a trauma patient can be categorized as:I. Haemodynamically 'normal' -investigations can be full and treatment planned.II. Haemodynamically 'stable' -investigations are more limited and are aimed at establishing whether the patient can be managed non-operatively.III. Haemodynamically 'unstable' -immediate surgical correction of bleeding is

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