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>Journals >Cirujano General >Year 2017, Issue 4


Gamboa HSI, Cárdenas MMF
Demographic factors and clinical signs of patients with penetrating abdominal injury in Yucatán
Cir Gen 2017; 39 (4)

Language: Español
References: 17
Page: 214-220
PDF: 4. Kb.


Full text




ABSTRACT

Background: The rate of penetrating abdominal injury (PAI) with stab wounds in the state of Yucatán is 57%; it is the leading cause of morbidity and disability in people in productive age. To date, nontherapeutic laparotomies have been described in 40%. It is difficult to consider a unique tool to predict the need for laparotomies, which has increased the interest to determine the characteristics of patients and the role of the clinical signs to establish the treatment of this pathology. Objective: To determine the demographic factors and clinical signs of penetrating abdominal injuries in patients admitted in the General Hospital Agustín O’Horán of the state of Yucatán. Material and methods: This is a retrospective study of 105 records of patients with penetrating anterior abdomen injuries who underwent surgery in a five-year period (January 2010 to December 2014) in the General Hospital Agustín O’Horán. Therapeutic and nontherapeutic laparotomies were compared. Gender, marital status, residence, body mass index, cause of injury, number of injuries, injured body area, age and clinical signs were analyzed. Results: Of 105 patients, 99 were male (94%), single, with an average age of 31.3 years, who lived in the interior of the state. The most frequent cause was personal violence, with a knife, in the epigastric zone, with a single wound associated with alcohol abuse. Forty-one patients (39%) had non-therapeutic laparotomy. We found a statistical association (p ‹ 0.05) regarding the place of residence, the clinical signs (heart rate higher than 80 beats per minute, breathing rate greater than 16 breaths per minute), peritonitis, and the result of therapeutic laparotomies. Conclusion: Surgical management cannot be discarded in patients with penetrating abdominal injury in asymptomatic and hemodynamic stability conditions; however hemodynamic instability and peritonitis are factors that should be considered for a therapeutic procedure.


Key words: Penetrating abdominal injury, clinical signs, stab wounds, therapeutic laparotomy, non-therapeutic laparotomy.


REFERENCIAS

  1. Pinedo OJ, Guevara TL, Sánchez AM. Trauma abdominal penetrante. Cir Ciruj. 2006; 74: 431-442.

  2. Oyo-Ita A, Ugare UG, Ikpeme IA. Surgical versus non-surgical management of abdominal injury. Cochrane Database Syst Rev. 2012; 11: 1-20.

  3. Sanei B, Mahmoudieh M, Talebzadeh H, Shahabi S, Aghaei Z. Do patients with penetrating abdominal stab wounds require laparotomy? Arch Trauma Res. 2013; 2: 21-25.

  4. Shaftan GW. Indications for operation in abdominal trauma. Am J Surg 1960; 99: 657-664.

  5. Paydar S, Salahi R, Izadifard F, Jaafari Z, Abasi H, Eshraghian A, et al. Comparison of conservative management and laparotomy in the management of stable patients with abdominal stab wound. Am J Emerg Med. 2012; 30: 1146-1151.

  6. Lapu K, Mathew M, Gende G, Kevau I. Selective surgical management of penetrating anterior abdominal wounds at the Angau Memorial Hospital: a prospective study. P N G Med J. 2011; 54: 48-52.

  7. Castillo JM, Enríquez DL, Herrera RF, Díaz RJ. Laparotomía no-terapéutica en trauma penetrante abdominal y su relación con el estado de intoxicación por alcohol y drogas. Cir Gen. 2011; 33: 232-235.

  8. Díaz-Rosales JD, Enríquez-Domínguez L, Castillo-Moreno J, Herrera-Ramírez F. Leucocitosis prequirúrgica como factor predictivo de lesión a órgano intrabdominal en trauma penetrante abdominal. Cir Cir. 2012; 80: 516-522.

  9. Romero-Peñalosa R. Trauma abdominal en el Hospital Escuela O’Horán. (Especialidad en Cirugía). Universidad Autónoma de Yucatán; 1989.

  10. Clarke S, Stearns A, Payne C, McKay AJ. The impact of published recommendations on the management of penetrating abdominal injury. Br J Surg. 2008; 95: 515-521.

  11. Instituto Nacional de Estadística y Geografía. Análisis sobre las principales adicciones en México (alcoholismo, drogadicción y tabaquismo) y sus respectivos programas de prevención. México, DF; 2013. pp. 96-115.

  12. Demetriades D, Hadjizacharia P, Constantinou C, Brown C, Inaba K, Rhee P, et al. Selective nonoperative management of penetrating abdominal solid organ injuries. Ann Surg. 2006; 244: 620-628.

  13. Nabeel S, Rushing A, Haut E, Kisat M, Villegas C, Chi A, et al. Outcome of selective non-operative management of penetrating abdominal injuries from the North American National Trauma Database. Br J Surg. 2011; 99: 155-165.

  14. Hasler RM, Nueschc E, Jüni P, Bouamra O, Exadaktylos A, Leckya F. Systolic blood pressure below 110 mmHg is associated with increased mortality in blunt major trauma patients: multicentre cohort study. Resuscitation. 2011; 82: 1202-1207.

  15. Colegio Americano de Cirujanos, Comité de Trauma. Programa avanzado de apoyo vital en trauma para médicos, 8.a edición. American College of Surgeons; 2008: 59-88. ISBN: 978-1-880696-37-8.

  16. Ertekin C, Yanar H, Taviloglu K, Guloglu R, Alimoglu O. Unnecessary laparotomy by using physical examination and different diagnostic modalities for penetrating abdominal stab wounds. Emerg Med J. 2005; 22: 790-794.

  17. Brahin A, Pero D. Tratamiento no quirúrgico de los traumatismos abdominales. In: Sociedad Argentina de Medicina y Cirugía de Trauma. Trauma, Prioridades. Buenos Aires, Argentina: Panamericana; 2002. pp. 310-113. ISBN: 950-06-20448.






>Journals >Cirujano General >Year 2017, Issue 4
 

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