Clinical management of abdominal trauma.
OBJECTIVE
To improve the prognosis of patients with abdominal trauma.


METHODS
Between January 1993 and December 2005, 415 patients were enrolled in this research. The patients consisted of 347 males and 68 females with mean age of 36 years (ranging from 3-82 years). All abdominal traumas consisted of closed traumas (360 cases, 86.7%) and open traumas (55 cases, 13.3%).


RESULTS
A total of 407 cases (98.1%) were fully recovered from trauma and the other 8 cases (1.9%) died of multiple injuries. The mean injury severity score (ISS) of all patients was 22 while the mean ISS of the patients who died in hospital was 42. Postoperative complications were seen in 9 patients such as infection of incisional wounds (6 cases), pancreatic fistula (2 cases) and intestinal fistula (1 case). All these postoperative complications were cured by the conservative treatment.


CONCLUSIONS
Careful case history inquisition and physical examination are the basic methods to diagnose abdominal trauma. Focused abdominal ultrasonography is always the initial imaging examination because it is non-invasive and can be performed repeatedly with high accuracy. The doctors should consider the severity of local injuries and the general status of patients during the assessment of abdominal trauma. The principle of treatment is to save lives at first, then to cure the injuries. Unnecessary laparotomy should be avoided to reduce additional surgical trauma.
Fang
Guo-en
GE
Department of General Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China. fangguoen@126.com
Luo
Tian-hang
TH
DU
Cheng-hui
CH
Bi
Jian-wei
JW
Xue
Xu-chao
XC
Wei
Guo
G
Weng
Zhao-zhang
ZZ
Ma
Li-ye
LY
Hua
Ji-de
JD
D000007:Abdominal Injuries / Q000175:diagnosis / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged