Non-standard situations in diagnostic process and treatment of obese patients coused by polytrauma
DOI:
https://doi.org/10.11603/2414-4533.2017.3.8019Keywords:
obesity, polytrauma, diagnostic, treatment.Abstract
The aim of the work: identifying problematic issues of diagnosis, medical care and treatment of polytrauma patients depending on the degree of obesity.
Materials and Methods. Clinical material is based on the observation of 51 polytrauma in patients treated in the Surgical Department of the Lviv Municipal Clinical City Hospital No. 8 in the perio d of 2009–2017.
Results and Discussion. Conventional diagnostic methods for blunt thoracic and abdominal trauma were sufficient in patients with normal body mass. In obese patients, the reliability of the objective survey data decreased, depending on the degree of obesity, which forced the surgeon to act non-standard, widely apply invasive techniques where it would be called no intervention. During the selection of treatment tactics, obese patients also traced certain features that, on the one hand, can be explained by the fact that even with relatively similar mechanisms of injury, obese individuals are more severely damaged, that is, the severity of the injury is directly proportional to the degree of obesity. But on another hand, compensatory properties of the body in people with normal body mass and initial manifestations of obesity, which managed one-stage intraoperatively to stop the bleeding, and to eliminate all intraabdominal damage.
Conclusions. Forming the diagnosis and treatment methods in polytrauma patients must be carried out taking into account the body mass index.
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