You lack the motivation to research the topic. You lack the courage to submit the original text for review. You are eager to Blunt Injury Abdomen Dissertation learn from a professional Blunt Injury Abdomen Dissertation to become seasoned in academic writing. You /10() Blunt Injury Abdomen Dissertation, Review Of Literature On Customer Satisfaction In Big Bazaar, Teacher Resources Writing A Research Paper, Top Annotated Bibliography Writers Sites For University Blunt abdominal trauma is a common cause for hospital admission worldwide as it occur in 31% patients of polytrauma and it is commonly secondary to Motor Vehicle Crash (MVC) [2]. Blunt abdominal injury can result in bleeding that could be intra peritoneal (13 from liver and 16% from spleen), pelvic (28%) or retroperitoneal [2]
The Role of Computed Tomography in Blunt Abdominal Trauma
Try out PMC Labs and tell us what you think. Learn More. To determine the utility of the computed tomography CT scan in blunt abdominal trauma and to compare it with operative findings or clinical outcomes. A retrospective analysis based on existing, diagnostic CT scan reports taken during a 5 year period from consecutive patients with blunt abdominal trauma, blunt injury abdomen dissertation. Percentages and types of trauma identified were based on CT scan findings. Recorded data included age, sex, type of injuries and scan results, blunt injury abdomen dissertation.
The CT findings were compared and correlated with the operative findings, or clinical follow-up in conservatively managed cases. There were 12 4. Hemoperitoneum were detected in patients. All 52 patients with small hemoperitoneum on CT scan were conservatively managed and all 22 patients with large hemoperitoneum required surgical exploration. There were 95 splenic, 63 renal, 48 hepatic and 13 pancreatic injuries.
Twenty one patients had bowel injuries. Five patients had vascular injuries. Twenty three patients had multi-organ injuries.
Organ injuries were graded using the OIS Organ Injury Scale guidelines. T he care of the trauma patient is demanding and requires speed and efficiency. Evaluating patients who have sustained blunt abdominal trauma BAT remains one of the most challenging and resource-intensive aspects of acute trauma care.
Missed intra-abdominal injuries continue to cause preventable deaths. Physical examination findings are notoriously unreliable for several reasons; a few examples are the presence of distracting injuries, an altered mental state, and drug and alcohol intoxication in the patient.
Coordinating trauma resuscitation demands a thorough understanding of the pathophysiology of trauma and shock, excellent clinical and diagnostic acumen, skill with complex procedures, compassion and the ability to think rationally in a chaotic milieu.
BAT usually results from motor vehicle collisions, assaults, recreational accidents, or falls. Men tend to be affected slightly more often than women. The most commonly injured organs are the spleen, liver, retroperitoneum, blunt injury abdomen dissertation, small bowel, blunt injury abdomen dissertation, kidneys, bladder, colorectum, diaphragm, and pancreas. The CT scan remains the criterion standard for the detection of solid organ injuries. CT scans, unlike direct peritoneal lavage DPL or Focused Assessment with Sonography for Trauma FAST examinations, have the capability to determine the blunt injury abdomen dissertation of haemorrhage.
In addition, many retroperitoneal injuries go unnoticed with DPL and FAST examinations. CT scans provide excellent imaging of the pancreas, blunt injury abdomen dissertation, duodenum and genitourinary system. The images can help quantitate blunt injury abdomen dissertation amount of blood in the abdomen and can reveal individual organs with precision. The limitations of CT scans include marginal sensitivity for diagnosing diaphragmatic, pancreatic and hollow viscus injuries.
Also, they are relatively expensive and time consuming and require oral or intravenous contrast, which may cause adverse reactions. Blunt injury abdomen dissertation this retrospective study, blunt injury abdomen dissertation, over a period of 5 years from May to Marchwe used abdomen CT scan reports available within the clinical charts of patients with BAT, who were stable enough to undergo radiological investigation in Prince Hashem Hospital in Zarqa, Jordan.
The age range was 14 - 72 years. Diagnostic peritoneal tapping was not performed in any of them. Patients with a normal CT scan and patients who either did not require admission, or who were discharged after a short, uneventful max. All CT scans were obtained with a Hi Speed Dual Helical CT scanner from General Electric. Oral contrast was not given to 23 patients with repeated vomiting or when limited information was required before proceeding for prompt laparotomy.
All patients received intravenous bolus of iodinated contrast agents. Following completion of the examination, the CT images were immediately reviewed by two specialist radiologists. They were in agreement on all the findings, blunt injury abdomen dissertation. Delayed CT scans were also incorporated whenever there was suspicion of kidney or urinary tract injury. Follow up CT scans were obtained for 14 patients, as dictated by the clinical course of the patient, but they did not contribute any further information.
Hemoperitoneum on CT was graded as described by Federle and Jeffrey et al. Individual organ injuries were graded according to the OIS Organ Injury Scale system.
from simple organic contusion to avascularisation of one organ. CT findings were compared with operative findings in patients, and with the clinical outcome and follow-up in conservatively managed patients.
The results were analysed with respect to hemoperitoneum quantification and OIS grades. The overall imaging findings were analysed for their role in guiding the therapeutic options, whether conservative or surgical. CT quantification of hemoperitoneum Federle et al.
Perisplenic space 2, blunt injury abdomen dissertation. Perihepatic space 3. Left paracolic gutter 5. Cul-de-sac in pelvis. Of the patients with blunt trauma, road traffic accident was the commonest mode of injury and it was the cause of abdominal trauma in patients.
In 40 patients, the injury was caused by fall from height. Nineteen patients had blunt injuries from other miscellaneous causes. There were 12 deaths, three of which were related to postoperative complications. The other nine patients died of associated head injuries within 24 hours. No autopsy results were available.
Hemoperitoneum was detected in All 52 patients with small fluid hemoperitoneum on CT were conservatively managed and all 22 patients with large hemoperitoneum required surgical exploration. CT quantification and management in patients with Themoperitoneum on CT examination. Among the solid organ injuries, the spleen was the commonest organ involved.
There were 95 Twenty one 8. Twenty three patients had multi-organ injuries [ Figs. Organ injuries were graded using the OIS guidelines. Nineteen of the 43 patients with moderate to severe grade III, IV and V injuries required surgery. Patient with multi organ injury: Grade V renal injury and shattered spleen. Sixty three patients had kidney injuries, 51 were unilateral and 12 bilateral. Of these 39 patients had grade III, 20 patients had grade IV and four patients had grade V [ Fig.
Only fourteen of the 63 patients with renal injury up to grade IV required surgery. All patients with grade V injury were operated upon as expected. Forty eight patients had liver injuries. Twenty nine had grade II and III [ Fig.
All grade V and 11 out of 15 grade IV liver injuries required surgery. The rest of the injuries were managed conservatively. Similarly, blunt injury abdomen dissertation, 13 patients had grade II and III pancreatic injuries. All these patients were managed conservatively.
Of the total patients in our study, CT OIS grading in these patients showed that all 62 patients with grade II injuries were conservatively managed, while 14 patients with grade V injuries were operated. However, the majority, i.
Hence, in the overall analysis of solid organ injuries, OIS grading in isolation did not appear to predict the management protocols in a small proportion of them.
CT-OIS grading and management in patients with solid organ injuries. For solid organ injuries the results were higher blunt injury abdomen dissertation specificity and the same for sensitivity.
Several studies have highlighted blunt injury abdomen dissertation inaccuracies of the physical examination in BAT, 6 however, CT requires a cooperative, haemodynamically stable patient. The accuracy of CT in haemodynamically stable blunt trauma patients has been well established. Most authors recommend admission and observation following a negative CT scan. We found good correlation between the CT quantification of the hemoperitoneum with the management approach.
All 52 patients with small fluid were conservatively managed and similarly all 22 patients with large fluid required surgical exploration.
Approximately half of the patients with moderate fluid were explored. Taylor et al. also reported a similar experience. CT is notoriously inadequate for the diagnosis of mesenteric injuries and may also miss hollow visceral injuries. In patients at risk for mesenteric or hollow visceral injury, DPL is generally felt to be a more appropriate test.
CT has the unique ability to detect clinically unsuspected injuries. Another advantage of CT scanning over other diagnostic modalities is its ability to evaluate the retroperitoneal structures 8 [ Fig 6 ].
Kane performed CT in 44 haemodynamically stable blunt trauma patients following DPL. In 16 patients, CT revealed significant intra-abdominal or retroperitoneal injuries not diagnosed by DPL. Note: blunt injury abdomen dissertation associated fracture involving the transverse process of L4 vertebra; it represents an anatomical entity at the level of aortic bifurcation.
BLUNT ABDOMINAL TRAUMA/ HOW TO APPROACH ?
, time: 23:14Blunt Trauma Abdomen Thesis
Of the patients with blunt trauma, road traffic accident was the commonest mode of injury and it was the cause of abdominal trauma in patients. In 40 patients, the injury was caused by fall from height. Nineteen patients had blunt injuries from other miscellaneous causes Blunt Injury Abdomen Dissertation, Achieve Goals In Life Essay, Politics Essay Competition , Mla Format Essay Using Quotes Blunt Injury Abdomen Dissertation You can order not only short essays with no particular topic but also complex research papers. They Blunt Injury Abdomen Dissertation know what kind of Blunt Injury Abdomen Dissertation paper will meet the requirements
No comments:
Post a Comment