RESUMO
Isolated near total small bowel mesenteric tear after blunt abdominal trauma is rare. We reported here an uncommon case with isolated near total small bowel mesenteric tear after blunt abdominal trauma. Early diagnosis of mesenteric tear is important and enhanced computed tomography is more sensitive for that kind of injury. Damage control laparotomy should be considered if unstable vital signs occurred.
RESUMO
OBJECTIVE To determine the prevalence of post-operative infections in patients who underwent damage control laparotomy(DCL) with abdominal packing and to identify the risk factors,mortality and predominant pathogens.METHODS A retrospective study of postoperative infections and microbiology in patients who underwent abdominal packing as an adjunct of DCL to control coagulopathic hemorrhage over a 5 year period(Feb 2002-Feb 2007) were performed.RESULTS A total of 26 patients were studied.Pneumonia/lower respivatory tract infection was the prominant type of infection(57.7%),followed by bacteremia(50.0%),urinary tract infection(15.4%) and wound infection(15.4%).Of the 244 organisms isolated from various sites,the most frequently isolated bacteria were Pseudomonas aeruginosa(27.0%),Staphylococcus species(15.6%),Acinetobacter baumannii(13.9%),and Klebsiella species(11.1%).No statistical correlation was found between positive packs and postoperative infection(P=0.10) or death(P=1.00).Multivariate regression analysis revealed that pre-existing abdominal infection(OR=22.4,P=0.02) and increased number of surgical procedures(OR=3.69,P=0.05) were the independent risk factors for post-operative infections.CONCLUSIONS Patients who undergo DCL with packing have a high incidence of postoperative infections.Pathogens and distribution are same as acquired infections.Pre-existing abdominal infection and increased number of surgical procedures are the independent risk factors for postoperative infections in these patients.