Intra-abdominal vascular injury secondary to penetrating trauma.
There were 85 patients in this series. The overall mortality was 17.6%. Gunshot wounds were responsible for 51 injuries, with a 21% mortality. There were three stabbings and three shotgun blasts, with a mortality of 10% and 33%, respectively. There were 127 intra-abdominal vascular injuries. The majority were to the SMA and its branches: 34. The highest mortality occurred with protal vein and combined aortic and vena caval injuries (80%). Fatalities averaged twice as many vascular injuries as survivors. There were 194 organ injuries. A liver injury predicted the highest mortality as did injuries to the spleen, lung, and pancreas. The presence of shock and the ability to rapidly control the source were the major predictors of survival. Fatalities averaged a Trauma Score of 7.5; survivors averaged a score of 14.0. There were 12 deaths which occurred intra-operatively and three postoperatively, for a total of 15 deaths. Once the patients made their way from surgery, their survival was 96% assured. Early suspicion of an intra-abdominal vascular injury followed by rapid exposure and control of hemorrhage are the keys to successful management.
Collins
P S
PS
Department of Surgery, Uniformed University of the Health Sciences, Bethesda, MD.
Golocovsky
M
M
Salander
J M
JM
Champion
H
H
Rich
N M
NM
D000007:Abdominal Injuries / Q000150:complications* / Q000401:mortality; D000328:Adult; D001808:Blood Vessels / Q000293:injuries*; D004219:District of Columbia; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D014193:Trauma Centers; D014950:Wounds, Penetrating / Q000150:complications* / Q000401:mortality