title: Urgent laparotomy versus emergency craniotomy for multiple trauma with head injury patients.
abstract: In blunt multiple trauma (MT) with head injury (HI) patients, it is difficult to decide whether to proceed with immediate laparotomy or craniotomy. In August 1989, abdominal ultrasonography (US) using a simple US scoring system was introduced for MT and HI patients as an initial rapid screening procedure. In MT and HI patients with a US score > or = 3 (n = 14), urgent laparotomy was the procedure of first choice. However, immediate head CT scan, then emergency craniotomy, may be justified in hemodynamically stable MT and HI patients with a US score < 3 (n = 98). Appropriate decision making can be applied to decide which procedure is most exigent.
authors.affiliation: Department of Surgery, National Yang-Ming Medical College, Taiwan, R.O.C.
authors.forename: M S
authors.initials: MS
authors.lastname: Huang
authors.forename: H C
authors.initials: HC
authors.lastname: Shih
authors.forename: J K
authors.initials: JK
authors.lastname: Wu
authors.forename: T J
authors.initials: TJ
authors.lastname: Ko
authors.forename: V K
authors.initials: VK
authors.lastname: Fan
authors.forename: R G
authors.initials: RG
authors.lastname: Pan
authors.forename: C I
authors.initials: CI
authors.lastname: Huang
authors.forename: L S
authors.initials: LS
authors.lastname: Lee
authors.forename: P I
authors.initials: PI
authors.lastname: Hsu
authors.forename: J M
authors.initials: JM
authors.lastname: Lin
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging; D000293:Adolescent; D000328:Adult; D000368:Aged; D003399:Craniotomy; D003657:Decision Making; D005260:Female; D016489:Head Injuries, Closed / Q000150:complications* / Q000601:surgery*; D006801:Humans; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D013995:Time; D014463:Ultrasonography