Tratamiento no operatorio en traumatismo cerrado de abdomen en el Hospital Municipal Dr. Leónidas Lucero: nuestra experiencia / Nonoperative treatment of blunt abdominal trauma at the Municipal Hospital Dr. Leonidas Lucero
Rev. argent. cir
;
108(4): 1-10, dic. 2016. tab
Article
in Spanish
| LILACS, BINACIS
| ID: biblio-957885
RESUMEN
Antecedentes existe una tendencia creciente hacia el tratamiento no operatorio (TNO) en el trauma-tismo cerrado de abdomen (TCA), en pacientes estables hemodinámicamente, sin abdomen agudo peritoneal. No hay consenso sobre momento de inicio de la dieta, deambulación, proflaxis anttrom-bótica, seguimiento y control, y reinicio de la actividad fisica. Objetivo:
describir los resultados del manejo de pacientes con TCA, admitidos en nuestro Servicio de Cirugía. Material ymétodos:
incluimos pacientes mayores de 15 años internados desde enero de 2011 hasta septembre de 2014, con TCA sometidos a TNO. Se recabaron las variables analizadas de una base de datos electrónica de fichaje prospectivo.Resultados:
del total de pacientes 31 TCA, 15 se intervinieron quirúrgicamente al ingreso y 16 pacientes se someteron a TNO. El 73,3% presentó lesiones asociadas extraabdominales. A todos se les realizó ecografa abdominal, donde se encontró líquido libre en el 80% y se identificó lesión de órgano sólido en el 60%. En 11 pacientes se realizó TC confrmando lesión objetivada en la ecografa e iden-tificando 3 no evidenciadas previamente. Se diagnosticaron 5 traumatismos hepáticos, 2 asociados a traumatismo renal; 6 traumatismos esplénicos, 4 renales y un paciente con hemoperitoneo. En 7 pacientes se utlizó tromboproflaxis. El TNO fue exitoso en todos los casos. Tres pacientes presentaron complicaciones. No se registró mortalidad.Conclusiones:
los pacientes sometidos a TNO en nuestro hospital fueron tratados exitosamente en todos los casos. No se registró mortalidad en la serie analizada.ABSTRACT
Background:
there is a growing trend towards non-operative management (NOM) in the blunt abdominal trauma (BAT) in hemodynamically stable patentis without peritoneal acute abdomen. However, there is stll no consensus on tme of onset of diet, ambulaton, antthrombotic prophylaxis, follow-up, and resumpton of physical activity.Objective:
to describe the management of patentis with BAT, admited to the Department of Surgery of our insttuton. Material andmethods:
we included patentis age 15 and older admited from January 2011 to Sept-ember 2014, with BAT who underwent NOM. The variables analyzed were collected from an electronic database of prospective signing. Resultis 31 TCA were identifed, 15 were operated on at admission and 16 patentis underwent NOM. 75% were men; mean age of 29 (range 18-58). In 100% abdominal ultrasound was performed, finding free fuid in 80% and identifying organ damage in 60% of the total. In 11 patentis CT scan was perfor-med confrming identifed organ injury on ultrasound and diagnosing three not evidenced previously. We included 5 patentis with liver trauma, 2 associated renal trauma; 6 splenic trauma; 4 kidney trauma and 1 patent with hemoperitoneum. Thromboprophylaxis was used in 7 patentis. NOM was successful in all cases. Three patentis presented complicatons, not associated with trauma. No mortality was recorded.Conclusions:
patentis undergoing NOT in our hospital were successfully treated in all cases. There were no complicatons associated with management of the NOT. No mortality was recorded.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Abdominal Injuries
Type of study:
Diagnostic study
/
Observational study
/
Prevalence study
/
Prognostic study
/
Risk factors
Limits:
Adolescent
/
Adult
/
Humans
/
Male
Country/Region as subject:
South America
/
Argentina
Language:
Spanish
Journal:
Rev. argent. cir
Journal subject:
General Surgery
Year:
2016
Type:
Article
Affiliation country:
Argentina
Institution/Affiliation country:
Hospital Municipal de Agudos Dr. Leónidas Lucero/AR
Similar
MEDLINE
...
LILACS
LIS