Small bowel trauma: current approach to diagnosis and management

[...]of this review, Shaftan stated that the management of abdominal trauma should change and that the indications for laparotomy be the same as those used in general abdominal surgery. [...]in major trauma centers, physical examination has proven unreliable in the majority of patients because of al...

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Bibliographic Details
Published in:The American surgeon 2014-12, Vol.80 (12), p.1183-1191
Main Authors: Barnett, Rebecca E, Love, Katie M, Sepulveda, Ernesto A, Cheadle, William G
Format: Article
Language:English
Subjects:
Abdomen
Abdominal Injuries - diagnosis
Abdominal Injuries - mortality
Abdominal Injuries - therapy
Antibiotics
Female
Humans
Injuries
Injury Severity Score
Intestine, Small - injuries
Intestine, Small - surgery
Laparoscopy
Laparoscopy - methods
Laparotomy - methods
Magnetic Resonance Imaging - methods
Male
Medical diagnosis
Mortality
Multivariate analysis
Patients
Peritoneal Lavage - methods
Prognosis
Risk Assessment
Seat belts
Survival Rate
Tomography, X-Ray Computed - methods
Trauma centers
Treatment Outcome
Wounds, Nonpenetrating - diagnosis
Wounds, Nonpenetrating - therapy
Wounds, Penetrating - diagnosis
Wounds, Penetrating - therapy
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Summary:[...]of this review, Shaftan stated that the management of abdominal trauma should change and that the indications for laparotomy be the same as those used in general abdominal surgery. [...]in major trauma centers, physical examination has proven unreliable in the majority of patients because of altered mental status and abdominal wall injury, so imaging has supplanted it for most patients. Since 1942, surgeons have recognized the increased mortality associated with delayed intervention and called for a heightened index of suspicion and laparotomy based on suspicion of small bowel injury alone.2, 3 The morbidity of a nontherapeutic laparotomy should be balanced with the more severe consequences of a delay in diagnosis and treatment of a potentially life-threatening hollow viscous injury.
ISSN:0003-1348
1555-9823