Asensio JA, Petrone P, Karsidag T, Demiray S, Kuncir E

Language: Spanish
References: 26
Page: 238-245
PDF size: 101.88 Kb.

ABSTRACT

Introduction: Abdominal vascular injuries present the highest mortality and morbidity indices among all the lesions that can be encountered in a traumatized patient.
Objective: Review of the clinical aspects, diagnosis, surgical approaches, and treatment of the patients with vascular intra-abdominal injuries.
Setting: Third level health care university hospital.
Method: Review and analysis of the pertinent literature (26 references) and of the clinical experience of the authors.
Results: Penetrating abdominal injuries constitute 90-95% of the lesions that affect the abdominal vessels. Multiorgan abdominal injury is frequent. Clinical findings compatible with hemoperitoneum or peritonitis and absence of femoral pulse are to be considered for laparotomy. Those patients presenting cardio-respiratory arrest must be subjected to emergency thoracotomy for open cardiac massage and aortic clamping. Global mortality is of 54%, exsanguination accounts for 85% of this mortality. The compartmental syndrome in the abdomen and extremities, as well as the vicious cycle of acidosis, hypothermia, and coagulopathy are the main complications.
Conclusion: Vascular abdominal injuries present a high mortality and morbidity. The anatomic knowledge of the retroperitoneum and the approaching pathways to the vessels, as well as an adequate clinical exploration, will be instrumental in decreasing complications and mortality in these patients.

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