By Harry M. Delany M.D., F.A.C.S., Robert S. Jason M.D. (auth.)
Trauma to the stomach, either unintended and willful, has turn into more and more universal during this period of accelerating violence. huge numbers of sufferers all around the nation are admitted to emergency rooms as a result of belly trauma of various levels of severity. All too usually the right kind prognosis is suspected belatedly or by no means, in order that right therapy isn't initiated in adequate time to be lifesaving. now not infre quently, the injured sufferer is tested through an intern or an insufficiently skilled resident health professional. Even in circumstances the place extra senior internists and surgeons can be found, targeted wisdom in regards to the worthwhile method to set up the right kind prognosis and institute the perfect remedy is missing. This monograph, representing the felicitous collaboration of a general practitioner and a radiolo gist including numerous different participants, is well timed and demanding. The authors (and their individuals) have approached their topic with a wealth of scientific experi ence bought in numerous very lively acute-care municipal hospitals within the greatest urban during this state. they've got saw and handled a truly huge variety of sufferers with a large number of worrying motives, together with firearm accidents, stab wounds, vehicular injuries, falls, and attacks. The authors have divided this paintings into 4 major sections: common views on stomach damage, different types of belly accidents, particular Diagnostic options, and particular Organ or Supporting-Structure Injury.
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Additional resources for Abdominal Trauma: Surgical and Radiologic Diagnosis
Lowe RJ, Boyd DR, Folk FA, Baker RJ (1972) The negative laparotomy for abdominal trauma. J Trauma 12: 853-860 24. Martin JD (1969) Trauma to the Thorax and Abdomen. Charles C Thomas, Springfield, Ill. 25. Mathewson C Jr (1969) Routine exploration of stab wounds of the abdomen. J Trauma 9: 1028-1030 26. McAlvanah MJ, Shaftan GW (1978) Selective conservatism in penetrating abdominal wounds: A continuing appraisal. J Trauma 18: 206 27. McCort JJ (1973) Abdominal trauma. In: Margulis AR, Burhenne HJ (eds) Alimentary Tract Roentgenology, Vol.
45. Three-point-belt in- dents: Additional injuries juries Soft tissue Abdominal wall Spleen Omentum Pancreas Uterus Urethra Iliac artery Rupture diaphragm Liver Fractures Extremities Pelvis Facial Total Fractures Rib, single Rib, multiple Sternum Clavicle Abdomen Organs unknown Jejunum, perforation Duodenum, perforation. Contusions and abrasions Chest Lap area Shoulder Neck Back Other 8 4 2 2 2 6 4 3 35 Source: Williams JS, Kirkpatrick JR (1971) The nature of seat belt injuries. J Trauma 11(3): 207-218 20 8 4 5 3 3 II 5 4 4 2 I Source: Williams JS, Kirkpatrick JR (1971) The nature of seat belt injuries.
Injury to the liver or spleen may produce pain in the epigastrium or flank, but there may also be pain in the shoulders from diaphragmatic irritation. If the hepatic or splenic injury is localized to the posterior surfaces, it may irritate the undersurfaces of the diaphragm with very little associated peritoneal reaction; thus, a history of shoulder pain, difficulty in breathing, or shortness of breath in the abdominal injury case has special significance. The referral of pain to the tip of the shoulder was described by Kehr as an important diagnostic sign in patients with splenic injury .