[Intestinal-mesenteric lesions of closed abdominal traumas].
A retrospective series of 24 intestinomesenteric lesions after blunt abdominal trauma were investigated to determine the distribution of the lesions as a function of the type of accident and to establish diagnostic and therapeutic patterns based on observed post-operative results. The chi squared test was used for statistical analysis. There were 20 men and 4 women, mean age 39 +/- 15 years (range 17-74). Trauma was caused by a traffic accident in 16 cases (67%) including 12 victims under 40 (p < 0.01) and 14 drivers (87.5%) (12 wore a safety belt). Haemodynamic instability or generalized abdominal defense. Pneumoperitoneum was seen on only one of the 21 (5%) admission X-rays. Abdominal echography was often ordered (16 times). The mean interval between trauma and surgical intervention was 39 hours. Injury involved the mesentery (n = 15), the small intestine (n = 14), the colon (n = 7) and the colic mesenteriolum (n = 4). Lesions of the colon were observed more often in automobile accidents (p < 0.05). Injury to other abdominal organs was also observed in 12 patients: liver (n = 6), spleen (n = 5) and pancreas (n = 5). The thorax was involved in 14 patients including 11 under 40 (p < 0.01). Nine intestinal resections/anastomoses, 9 enterroaphies (including 4 colic injuries) and 1 Hartman were performed. Two patients died (8.3%) and follow-up was complicated in 14 (including the 2 deaths). Wearing the safety belt did not affect the greater number of intestinomesenteric lesions. In subjects wearing a safety belt, there were more injuries of the thorax but less neurological involvement.(ABSTRACT TRUNCATED AT 250 WORDS)
Kunin
N
N
Service de Chirurgie Générale A, C.H.R. de Rennes, Hôpital Sud.
Letoquart
J P
JP
La Gamma
A
A
Chaperon
J
J
Mambrini
A
A
D000007:Abdominal Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D003108:Colonic Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D008297:Male; D008643:Mesentery / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D010532:Peritoneal Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D011027:Pneumoperitoneum / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
Les lésions intestino-mésentériques dans les traumatismes abdominaux fermés.