medigraphic.com
ISSN 1029-3019 (Electronic)

2013, Number 03

MediSan 2013; 17 (03)

Morbidity and mortality from abdominal trauma during four year-period 2007-2010

Merilien F, Cisneros DCM, Escalona CJA, Rodríguez FZ, Romero GLI

Language: Spanish
References: 20
Page: 435-448
PDF size: 127.72 Kb.


ABSTRACT

Introduction: Injuries are the third cause of death in developed countries. In Cuba they represent the fourth and the first one in people younger than 50 years.
Objectives: To characterize patients with abdominal trauma according to selected variables and to determine their status at discharge.
Methods: An applied descriptive study was carried out in a sample of 346 patients with abdominal trauma (surgically treated or not), who were discharged from the Department of General Surgery of “Saturnino Lora” Provincial Teaching Clinical Surgical Hospital of Santiago de Cuba during the fourth year-period 2007-2010.
Results: Open trauma caused by stab wound and abdominal ultrasound as the most valuable diagnostic tool prevailed. Therapeutic laparotomies were performed in 61.2% of patients undergoing surgery due to injuries in liver, small bowel and spleen, for surgeries of hepatorrhaphy, intestinal resection and splenectomy, respectively. The most common complications were hemorrhagic shock (main cause of death) and infection of the surgical site.
Conclusions: Frequency of unnecessary laparotomies remains high and to prevent them it is recommended reducing the time between injury and surgery, which is critical to maintain the hemodynamic stability of the patient that allows conducting diagnostic studies (computerized tomography and videolaparoscopy) and the relevant treatments.


REFERENCES

  1. Wilson WC, Grande CM, Hoyt DB. Trauma: emergency resuscitation, peroperative anesthesia surgical management. Vol 1. New York: Informa Healthcare; 2007. p. 5–123.

  2. García Gutiérrez A. Traumatismos del abdomen. En: García Gutiérrez A, Pardo Gómez G, Abraham Arap JF, Adefna Pérez RI, Arce Bustabad S, Barrero Soto R, et al. Cirugía. La Habana: Editorial Ciencias Médicas; 2007. p. 648–77.

  3. Soler Vaillant R, Pérez Cardenas JC. Lesiones traumáticas abdominales. En: Soler Vaillant R, Pérez Cardenas JC. Cirugía del abdomen. La Habana: Editorial Ciencias Médicas; 2010. p. 155-230.

  4. Álvarez Cambras R. Tratamiento de urgencias a traumatizados. En: Tratado de cirugía ortopédica y traumatológica. 2 ed. La Habana: Editorial Ciencias Médicas; 2009. p. 63-95.

  5. Caballero López A, Bécquer García EA, Domínguez Perera MA, Acosta Armas F, Castro Expósito A, Martínez Peralta MR, et al. Terapia intensiva. La Habana: Editorial Ciencias Médicas; 2009. p. 52-9, 11-117.

  6. Méndez Catasús R. Traumatismos del abdomen y pelvis. Rev Cubana Cir. 2006[citado 12 Ene 2011];45(3-4). Disponible en: http://bvs.sld.cu/revistas/cir/vol45_3_06/cir16306.html

  7. Caballero López A, Béquer García EA, Domínguez Perera MA, Acosta Armas F, Castro Expósito A, Martínez Peralta MR, et al. Terapia intensiva. t4. La Habana: Editorial Ciencias Médicas; 2009. p. 1637-1700.

  8. Maull KI. Current status of non operative management of liver injuries. World J Surg. 2001;25(11):1403-4.

  9. Baskir MM, Abu-Zidan FM. Damage control surgery for abdominal trauma. Eur J Surg (Suppl). 2003;588:8-13.

  10. Mathonnet M, Peyrou P, Gainant A, Bouvier S, Cubertafond P.

  11. Cáceres Loayza ES. Correlación entre hallazgos ultrasonográficos y hallazgos quirúrgicos en pacientes con traumatismo abdominal cerrado. Hospital de Apoyo “María Auxiliadora” Lima: enero-diciembre 2001. 2003 [citado 13 Dic 2010]. Disponible en: http://www.cybertesis.edu.pe/sisbib/2003/caceres_le/html/sdx/caceres_le.html

  12. Hammond J, Bermann M, Chen B, Kushins L. Incorporation of a computerized human patient simulator in critical care training: a preliminary report. J Trauma. 2002;53(6):1064-7.

  13. Cuba. Ministerio de Salud Pública. Anuario Estadístico de Salud 2010. La Habana: MINSAP;2011 [citado 8 Dic 2011]. Disponible en: http://files.sld.cu/dne/files/2011/04/anuario-2010-e-sin-graficos1.pdf

  14. Lucas CE, Crawford RS. Diagnostic modalities for penetrating abdominal injuries. Panam J Trauma. 2004;11(2):1-5.

  15. Infante Carbonell MC, Cabrera Salazar J, Puertas Álvarez JF. Morbilidad y mortalidad por traumatismo con lesión visceral. MEDISAN. 2010[citado 8 Dic 2011];14(7). Disponible en: http://scielo.sld.cu/scielo.php?pid=S1029- 30192010000700011&script=sci_arttext

  16. Sánchez Portela CA, Delgado Fernández JC, Robaina Arias LE, Simón Rodríguez L, Díaz Arteaga Y. Morbilidad y mortalidad por traumatismo abdominal. 2002 a 2004. Rev Cubana Cir. 2007[citado 14 abr 2010];46(3). Disponible en: http://bvs.sld.cu/revistas/cir/vol46_3_07/cir07307.htm

  17. Carballo Avendaña J. Complicaciones por laparotomía exploradora por trauma cerrado de abdomen en el Hospital Escuela Dr. Roberto Calderón Gutiérrez, Enero 1999-diciembre 2003. [consulta 14 Abr 2011]. Disponible en: http://bases.bireme.br/cgibin/ wxislind.exe/iah/online/?IsisScript=iah/iah.xis&src=google&base=LILACS&lang =p&nextAction=lnk&exprSearch=383128&indexSearch=ID

  18. Patiño Restrepo JF. Trauma pancreático y duodenal. [citado 12 Mar 2009]. Disponible en: http://www.aibarra.org/Guias/2-10.htm

  19. De Waele J, Vermassen FF. Coagulopathy, hypothermia and acidosis in trauma patients. Act Belg.2002;102(5):313-16.

  20. Cohn SM, Nathens AB, Moore FA, Rhee P, Puyana JC, Moore EE, et al. Tissue oxygen saturation predicts the development of organ dysfunction during traumatic shock resuscitation. J Trauma. 2007;62(1):44-54.




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