RESUMO
The authors have analyzed results of treatment of 641 patients with the liver injury: blunt injury--209, penetrating--432. Surgical strategy depends on the condition of the patient on admission, severity of the liver injury and combined trauma. Suturing the rupture (wound) of the liver was the method of choice in the I-II degrees of the liver injury. If it was impossible to achieve hemostasis in the bottom of the wound in the III-IV degrees of the liver injury, package with gauze drain (7) and ligation of the hepatic artery (3) were used. Resection of the liver was performed in 22 patients. In the postoperative period the main complications were: peritonitis (22), subphrenic abscesses (13), hemobilia (7), subhepatic abscesses (6) and liver abscesses (5). Embolization of the hepatic artery branches was preferable in hemobilia. The mortality rate in blunt injuries of the liver was 28.2%, gunshot wounds--27.6% and knife injury--4%.
Assuntos
Abscesso Abdominal/cirurgia , Traumatismos Abdominais/cirurgia , Drenagem/métodos , Laparotomia/métodos , Fígado/lesões , Técnicas de Sutura , Abscesso Abdominal/epidemiologia , Abscesso Abdominal/etiologia , Traumatismos Abdominais/complicações , Traumatismos Abdominais/mortalidade , Seguimentos , Humanos , Incidência , Fígado/cirurgia , Federação Russa/epidemiologia , Taxa de SobrevidaAssuntos
Traumatismos Abdominais , Corpos Estranhos , Traumatismo Múltiplo , Traumatismos Abdominais/diagnóstico por imagem , Traumatismos Abdominais/etiologia , Traumatismos Abdominais/cirurgia , Adulto , Aorta Abdominal/lesões , Aorta Abdominal/cirurgia , Colo/diagnóstico por imagem , Colo/lesões , Diagnóstico Diferencial , Duodeno/diagnóstico por imagem , Duodeno/lesões , Feminino , Corpos Estranhos/diagnóstico por imagem , Corpos Estranhos/etiologia , Corpos Estranhos/cirurgia , Humanos , Laparotomia , Masculino , Radiografia , Ferimentos Perfurantes/complicações , Ferimentos Perfurantes/diagnóstico por imagem , Ferimentos Perfurantes/cirurgiaRESUMO
The authors have substantiated the necessity of elaboration and introduction of a single all-state++ system of objective quantitative evaluation of the severity of the injuries. A brief comparative characteristic of the most popular Soviet and foreign systems of the severity of the injuries is presented. The synthesized scales (elaborated at the prognosis laboratory of the Central Institute of Traumatology and Orthopedics ) for a quantitative evaluation of the character and the localization of the fractures are presented.
Assuntos
Escala de Gravidade do Ferimento , Traumatismo Múltiplo/classificação , Índices de Gravidade do Trauma , Ferimentos e Lesões/classificação , Adulto , Criança , Humanos , Traumatismo Múltiplo/diagnóstico , U.R.S.S. , Ferimentos e Lesões/complicações , Ferimentos e Lesões/diagnósticoAssuntos
Diafragma , Adolescente , Adulto , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Doenças Musculares/cirurgiaRESUMO
Experience with the treatment of 33 patients with injuries of the duodenum is presented: 17 patients with ruptures of the duodenum, 16 patients with wounds. Post-operative complications were developed in 21 patients, 13 patients died. The two-row suture of the wound and decompression by nasogastroduodenal probe are considered by the authors to be the adequate operation for most of the patients.
