ABSTRACT
Blunt abdominal trauma can damage the intestinal vasculature and may occasionally lead to delayed intestinal perforation, associated with a combined rate of morbidity and mortality of 25%. The diagnosis of such complications is hindered by sedation in critical patients, however, and morbimortality in this population is therefore higher. We report the case of a man with multiple injuries admitted to the intensive care unit, where delayed perforations of the sigmoid colon and cecum were diagnosed. The management of blunt abdominal trauma is reviewed and the possible causes, diagnostic approaches, and treatment options for colon injuries are discussed.
Subject(s)
Abdominal Injuries/complications , Cecum/injuries , Colon, Sigmoid/injuries , Intestinal Perforation/etiology , Multiple Trauma/complications , Wounds, Nonpenetrating/complications , Abdominal Injuries/surgery , Adult , Cecum/surgery , Colon, Sigmoid/surgery , Humans , Intestinal Perforation/surgery , Male , Time Factors , Wounds, Nonpenetrating/diagnosis , Wounds, Nonpenetrating/surgeryABSTRACT
El traumatismo abdominal cerrado puede conducir alesiones en los vasos sanguíneos intestinales y excepcionalmentea una perforación intestinal diferida con unamorbimortalidad asociada del 25%. Sin embargo, en lospacientes críticos bajo sedación y analgesia, la exploraciónabdominal y su diagnóstico están interferidos, siendola morbimortalidad mayor. Presentamos el caso deun paciente politraumatizado ingresado en una Unidadde Reanimación que presentó una perforación doble,diferida, de sigma y ciego. Se revisa el manejo del traumatismoabdominal cerrado y se discuten las posibilidadesetiológicas, diagnósticas y terapéuticas en el traumatismode colon
Blunt abdominal trauma can damage the intestinal vasculature and may occasionally lead to delayed intestinal perforation, associated with a combined rate of morbidity and mortality of 25%. The diagnosis of such complications is hindered by sedation in critical patients, however, and morbimortality in this population is therefore higher. We report the case of a man with multiple injuries admitted to the intensive care unit, where delayed perforations of the sigmoid colon and cecum were diagnosed. The management of blunt abdominal trauma is reviewed and the possible causes, diagnostic approaches, and treatment options for colon injuries are discussed
Subject(s)
Humans , Male , Adult , Intestinal Perforation/therapy , Cecum/injuries , Colon/injuries , Abdominal Injuries/complications , Multiple Trauma/complications , Drainage/methods , Peritonitis/diagnosis , Hematoma/complications , ColectomySubject(s)
Gastroenteritis/etiology , Gastrointestinal Hemorrhage/etiology , Shock/etiology , Whipple Disease/diagnosis , Aged , Anti-Bacterial Agents , Cardiotonic Agents/therapeutic use , Combined Modality Therapy , Critical Care , Diagnosis, Differential , Diuretics/therapeutic use , Drug Therapy, Combination/therapeutic use , Humans , Hypertrophy, Left Ventricular/complications , Inflammatory Bowel Diseases/diagnosis , Male , Pericardial Effusion/etiology , Water Deprivation , Whipple Disease/therapyABSTRACT
Our study has been made on a retrospective basis in order to evaluate the efficacy of somatostatin (SST) in the treatment of acute haemorrhage caused by gastroduodenal ulcer. Sixty patients were allocated in 2 groups: those who received SST (n = 30), and those who did not received it (n = 30), and were treated only with conventional measures (nasogastric catheter, H2 blockers, blood or derivatives, etc.). Both groups were monitored and controlled at the Anesthesia-Intensive Care Unit. The patients in the SST group received a continuous intravenous infusion of 250 micrograms/h. These patients showed better hemodynamic parameters, and only seven needed surgery. The patients in the conventional treatment group showed worse hemodynamics, needed higher volumes of hemoderivatives, and 25 of them needed surgery. The statistical analysis of our data supports the efficacy of SST in the treatment of uncontrollable upper gastrointestinal bleeding due to gastroduodenal ulcer.
