Diagnostic and therapeutic tactics for closed abdominal injury
DOI:
https://doi.org/10.11603/2414-4533.2023.2.13833Keywords:
closed abdominal injury, diagnosis, treatmentAbstract
The aim of the work: to assess the effectiveness of diagnostic search and provision of surgical care to patients with closed abdominal trauma in emergency hospital.
Materials and Methods. The experience of treatment of 257 patients with closed trauma of the abdominal cavity who were on treatment in the Surgical Department of the Ternopil City Communal Emergency Hospital for the period 2016 to 2022 was analyzed.
Physical and laboratory research methods were used in 100 % of cases. Among the instrumental diagnostic methods, ultrasound examination according to the FAST protocol was used in 89.1 %, computer tomography – 36.7 %, laparoscopy – 78.2 %, laparocentesis – 3.9 %.
Statistical processing was carried out using methods of medical statistics.
Results and Discussion. Analysis of the results of the study allowed in 34.6 % of patients with hemoperitoneum to use conservative therapy with strict adherence to its criteria: absence of damage to hollow organs, presence of consciousness, stability of hemodynamics, damage to a parenchymal organ no more than III degree based on the OIS scale, hemoperitoneum up to 500 ml.
A thorough examination of the patient and a differentiated approach to treatment allows in 64.2 % of cases to eliminate the pathological process by means of minimally invasive laparoscopic methods.
Laparoscopic operations for injuries were completed with thorough revision, sanitation and drainage of the abdominal cavity. We did not observe any complications associated with endovideosurgery in this group of patients. There were no fatal consequences, which is caused primarily by careful selection of patients. The use of minimally invasive laparoscopic methods of treatment in this group of patients contributes to the reduction of the severity of surgical trauma and the frequency of various postoperative complications.
Therefore, for the successful treatment of the above patients, it is necessary to use a comprehensive examination, which allows to reduce the time of diagnostic search and to determine the tactics of differentiated treatment.
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