Álvarez-Ibarra S, de Atocha Rosado-Montero M, Padrón-Arredondo G

Language: Spanish
References: 12
Page: 37-41
PDF size: 729.94 Kb.

ABSTRACT

Introduction. Currently, violence in society has led to an increase in cases of abdominal vessel injuries and these occur in 10 to 20% of penetrating lesions, of which a third occur in the abdomen; however, the incidence of vascular injuries in closed trauma has decreased by 10%. Mortality in arterial lesions is estimated at 35 to 85% and 50 to 90% in venous lesions.
Clinical case. 16-year-old male admitted for gunshot wound (GSW) to abdomen. On admission, a complaining patient, with paleness of teguments, dehydrated and mydriasis. There is a 1 cm wound in the right lumbar and iliac fossa. Vital signs: blood pressure 90/40 mmHg, heart rate 160 bpm, respiratory rate 24 bpm, temperature 36 °C. Laboratory studies reported: Hb. 9.3, Ht. 27.2, glucose 282 mg/dL, rest normal. The patient goes into the operating room and makes a supra- and infra-umbilical mid incision, finding a 2 litre haemoperitoneum with a retroperitoneal haematoma. A vena cava lesion is located less than 1 cm from the confluence of the common iliac vessels. Cava venorrhage is performed with simple 5-0 nylon stitches.
Conclusion. Gunshot injuries have increased, so the surgeon must be aware that any penetrating injury to the torso, from the breast line to the upper third of the thighs, may present vascular injury, showing hemodynamic stability in case of hematomas, or shock when there is free blood with possible exsanguination.

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