| Title |
Atviri plonosios žarnos sužalojimai / |
| Translation of Title |
Penetrating small bowel injury. |
| Authors |
Gaidamonis, Edmundas Vladas ; Stanaitis, Juozas ; Tamulis, Sigitas ; Saltanavičius, Robertas ; Tutkus, Rytis ; Brazauskas, Kazimieras ; Grigaliūnas, Aurelijus ; Račinas, Moisiejus ; Stasinas, Jonas ; Saladis, Tomas ; Lunevičius, Raimundas |
| DOI |
10.15388/LietChirur.2003.2.2430 |
| Full Text |
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| Is Part of |
Lietuvos chirurgija.. Vilniaus universiteto leidykla. 2003, 2003. t. 1, Nr. 2, p. 170-182.. ISSN 1392-0995. eISSN 1648-9942 |
| Keywords [eng] |
penetrating abdominal trauma ; small bowel injury ; postoperative morbidity ; mortality ; abdominal trauma index |
| Abstract [eng] |
Background / objective To evaluate the results of treatment of patients with penetrating small bowel injuries and to determine the main factors affecting postoperative morbidity and mortality. Methods Medical records for 126 patients admitted with penetrating small bowel injuries between 1982 and 1998 were reviewed. The patients' age, ASA grade, presence of shock, method of diagnosis, injury grade according to OIS, penetrating abdominal trauma index, operative management, morbidity and mortality were taken into consideration. Results Isolated injuries were found in 47 cases (37.3%). Twenty patients (15.9%) had associated injuries of the organs of the other systems. Postoperative complications developed in 32 patients (25.4%), 6 patients died (mortality rate 4.8%). Postoperative complications were more frequent in patients with grade IV–V versus grade I–III of injury (60% versus 23.4%, p < 0.01). The complications were less in cases of a proximal part of small bowel injury (21.4%), versus a 36.5% complication rate in patients with injuries of the middle and distal parts of the small bowel (p = 0.05). The rate of postoperative complications was 3.6 times higher in patients with PATI over 25 than in patients with PATI from 2 to 25 (p < 0.001); the mortality rate was almost 12.8 times higher (p < 0.005). According to ASA, the rate of postoperative complications and mortality was 11.9% versus 52.9% (p < 0.01) and 1.8% versus 23.5% (p < 0.005) respectively in patients with ASA grade I–III and grades IV–V. Haemodynamical stability had no statistically reliable influence on the postoperative complication rate (40% in stable and 22.6% in unstable haemodynamic patients), but it had a statistically significant influence on mortality rate (15% with unstable and 2.8% with stable haemodynamics, p = 0.05). Conclusions Penetrating small bowel injuries were detected in 11.7% of patients operated on for abdominal trauma and in 18% of patients due to penetrating abdominal injuries. Isolated injuries were found in 37.3% of cases. Most of the patients were haemodynamically stable (84.2%), with grades I–III of injury (88.1%). The operation option was associated to the grade of the injury: primary repair was performed in 86% and resection in 13.5% of cases. The higher risk of complications and mortality rate was associated with a poor general condition (ASA grade IV–V), unstable haemodynamical status, grade of injury more than III, PATI more than 25, and injuries of the distal part of the small bowel. Tube enterodecompression had no influence on the suture insuffitiency rate. Keywords: penetrating abdominal trauma, small bowel injury, postoperative morbidity, mortality, abdominal trauma index. |
| Published |
Vilniaus universiteto leidykla |
| Type |
Journal article |
| Language |
Lithuanian |
| Publication date |
2003 |
| CC license |
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