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Jejunumabriss als isolierte abdominelle Verletzung. Unfallchirurg 2020; 123:244-246. [DOI: 10.1007/s00113-020-00775-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Pothmann CEM, Sprengel K, Alkadhi H, Osterhoff G, Allemann F, Jentzsch T, Jukema G, Pape HC, Simmen HP, Neuhaus V. [Abdominal injuries in polytraumatized adults : Systematic review]. Unfallchirurg 2018; 121:159-173. [PMID: 29350250 DOI: 10.1007/s00113-017-0456-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Abdominal injuries are potentially life-threatening and occur in 20-25% of all polytraumatized patients. Blunt trauma is the main mechanism. The liver and spleen are most commonly injured and much less often the intestines. The clinical evaluation proves equivocal in many cases; therefore, the gold standard is computed tomography (CT), which has been increasingly used even in hemodynamically weakly stable or sometimes even unstable patients because it promptly provides precise diagnostic findings, which present the basis for successful therapy. Hemodynamically unstable patients always need an exploratory laparotomy (EL). An EL should also be carried out with a positive focused assessment with sonography for trauma (FAST) or CT for severe parenchymal lesions, hollow organ lesions, intraperitoneal bladder lesions, peritonitis and organ evisceration, impalement injuries and lesions of the abdominal fascia. Hemodynamically stable patients without signs of peritonitis and a lack of such findings can often be treated conservatively irrespective of the extent of an injury. Angiography (and if needed embolization) can additionally be diagnostically and therapeutically utilized.
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Affiliation(s)
- C E M Pothmann
- Klinik für Traumatolgie, UniversitätsSpital Zürich, Rämistr. 100, 8091, Zürich, Schweiz
| | - K Sprengel
- Klinik für Traumatolgie, UniversitätsSpital Zürich, Rämistr. 100, 8091, Zürich, Schweiz
| | - H Alkadhi
- Institut für Diagnostische und Interventionelle Radiologie, UniversitätsSpital Zürich, Zürich, Schweiz
| | - G Osterhoff
- Klinik für Traumatolgie, UniversitätsSpital Zürich, Rämistr. 100, 8091, Zürich, Schweiz
| | - F Allemann
- Klinik für Traumatolgie, UniversitätsSpital Zürich, Rämistr. 100, 8091, Zürich, Schweiz
| | - T Jentzsch
- Klinik für Traumatolgie, UniversitätsSpital Zürich, Rämistr. 100, 8091, Zürich, Schweiz
| | - G Jukema
- Klinik für Traumatolgie, UniversitätsSpital Zürich, Rämistr. 100, 8091, Zürich, Schweiz
| | - H C Pape
- Klinik für Traumatolgie, UniversitätsSpital Zürich, Rämistr. 100, 8091, Zürich, Schweiz
| | - H-P Simmen
- Klinik für Traumatolgie, UniversitätsSpital Zürich, Rämistr. 100, 8091, Zürich, Schweiz.
| | - V Neuhaus
- Klinik für Traumatolgie, UniversitätsSpital Zürich, Rämistr. 100, 8091, Zürich, Schweiz
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Rare Case of Large Bowel Injury due to Direct Blunt Trauma to a Preexisting Femoral Hernia. Case Rep Surg 2017; 2017:5308027. [PMID: 29209550 PMCID: PMC5676415 DOI: 10.1155/2017/5308027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 08/09/2017] [Indexed: 11/17/2022] Open
Abstract
We report a case of an 85-year-old man with a known asymptomatic left femoral hernia who was admitted to the emergency ward a few hours after falling from a bicycle and suffering from blunt trauma of the handlebar to the left inguinal region. The clinical findings and a computed tomography (CT) scan detecting free air in the femoral hernia sac suggested bowel perforation. Emergency laparotomy 6 hours after the incident confirmed a tear of the sigmoid colon accompanied by free blood and faeces in the left inguinal region of the abdomen. A segmental sigmoid resection and a primary end-to-end colorectal anastomosis were performed. The postoperative course was complicated by delayed oral feeding, a local infection, and a partial left testicle necrosis that led to secondary resection. The patient was discharged after 32 days of in-hospital care. Three months post trauma, we recorded a restitutio ad integrum. The case exemplifies that blunt trauma to preexisting femoral hernias may cause potentially lethal bowel perforation and that the time interval between time of injury and surgical treatment may be a prognostic factor. CT scans seem most suitable for ruling out bowel perforation. The scarce literature for blunt trauma to hernias is reviewed.
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El Maksoud WMA. Isolated small bowel perforation due to blunt trauma to inguinal hernia: Report of a case and review of the literature. HELLENIC JOURNAL OF SURGERY 2016; 88:168-172. [DOI: 10.1007/s13126-016-0309-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Small bowel perforation due to blunt trauma to an inguinal hernia: a case report and literature review. Hernia 2010; 16:349-50. [PMID: 21125305 DOI: 10.1007/s10029-010-0755-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2010] [Accepted: 11/13/2010] [Indexed: 10/18/2022]
Abstract
We report the case of a 41-year-old man with a known right inguinal hernia presenting with groin pain following a fall while dog walking. Operative findings showed a small bowel perforation affecting the loop of bowel in the hernial sac. Bowel perforations caused by blunt abdominal injury in patients with an inguinal hernia is a rare and not well recognised problem, and are confined to a handful of case reports in the surgical literature.
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