2009, Number 2
Penetrating abdominal trauma with small bowel-circumscribed injury and injuries associated to other organs: relation regarding morbidity and mortality in Ciudad Juárez, Chihuahua, Mexico
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ABSTRACTObjective: To assess whether there are differences in morbidity and mortality between patients with penetrating abdominal trauma affecting only the small bowel and those with penetrating abdominal trauma affecting aside from the small bowel other abdominal organs.
Design: Cohort, longitudinal, comparative non-randomized analytical study.
Setting: General Hospital of Ciudad Juárez (second level health care hospital).
Statistical analysis: Percentages as summary measure of qualitative variables. Data were compared with Pearson’s χ2 test.
Patients and methods: Patients with penetrating abdominal trauma during a one-year period. Patients were divided in two groups: Group 1 constituted by patients with only small bowel injury and Group 2 patients with small bowel injury associated to injuries in another intra-abdominal organ. Variables studied were: age, gender, type of lesion, pre-operative period, injured intra-abdominal organ, extra-abdominal injuries, complications, mortality, and days of in-hospital stay.
Results: Seventy-one patients were studied (67 men and 4 women), with small bowel injury, average age of 26.4 years. Group 1 with 31 patients, group 2 with 40 patients, The most common associated injury was in the colon; group 1 suffered trauma made with a sharp stabbing object in 74%, whereas in group 2, injuries were caused by gunshots in 92.5%. Group 2 had a higher incidence (37.5%) of extra-abdominal injuries. Comparison of complications between the two groups yielded significant differences (p = 0.001), 12.9% vs 52.5% for group 1 and 2, respectively. Mortality was nil for group 1 and of 25% for group 2, with a statistically significant difference (p = 0.001).
Conclusions: Penetrating abdominal wounds, with injury to the small bowel plus another associated injury to an intraabdominal organ and/or extra-abdominal region increase morbidity and mortality.
Servicios Periciales y Ciencias Forenses. Procuraduría General de Justicia del Estado de Chihuahua. http://www. chihuahua.gob.mx/pgje
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