[Transport management in blunt abdominal trauma. Case report of a patient with delayed diagnosis of splenic rupture].
Missed abdominal injuries after blunt abdominal trauma belong to the most frequent causes of death, especially in polytraumatized patients. Primary missing these injuries often is a tragedy due to a mortality-rate up to 50% after delayed treatment compared with a low complication- and mortality-rate after diagnosis in time. We report the case of a patient with a missed spleen lesion to discuss the special problems of the transport stages. Transport and diagnostic procedures are critical stages because of limited diagnostical and therapeutical possibilities. There is a risk of inadequate therapy in case of a sudden debasement of the patient's condition. Therefore sufficient monitoring and the availability of emergency medicals and tools are essential to secure an adequate treatment of secondary decompensation. These conditions are indispensable for the primary transport, innerhospital transfers and also for secondary interhospital transfers. Supervision during the transport stages by a doctor who is able to carry out life-saving emergency treatments is essential. Sudden debasement of the patient's condition often requires short-dated decision making concerning the following diagnostical and therapeutical strategy.
Ambacher
T
T
Chirurgische Universitätsklinik, RWTH Aachen. TAmbacher@t-online.de
Riesener
K P
KP
Kasperk
R
R
Schumpelick
V
V
D000007:Abdominal Injuries / Q000175:diagnosis* / Q000601:surgery; D000328:Adult; D004632:Emergency Medical Services; D006465:Hemoperitoneum / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008297:Male; D009104:Multiple Trauma / Q000175:diagnosis / Q000601:surgery; D013161:Splenic Rupture / Q000175:diagnosis* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014187:Transportation of Patients; D014463:Ultrasonography; D014949:Wounds, Nonpenetrating / Q000175:diagnosis* / Q000601:surgery