Laparotomy for Abdominal Stab Wound With Combined Omental and Organ Evisceration: 10-Year Experience From a Major Trauma Centre in South Africa

2021 ◽  
pp. 000313482110318
Author(s):  
Victor Kong ◽  
Cynthia Cheung ◽  
Nigel Rajaretnam ◽  
Rohit Sarvepalli ◽  
William Xu ◽  
...  
Keyword(s):  
South Africa ◽  
Small Bowel ◽  
Large Bowel ◽  
Major Trauma ◽  
Stab Wound ◽  
Length Of Hospital Stay ◽  
Trauma Centre ◽  
Major Trauma Centre ◽  
The Mean ◽  
Overall Mortality

Introduction Combined omental and organ evisceration following anterior abdominal stab wound (SW) is uncommon and there is a paucity of literature describing the management and spectrum of injuries encountered at laparotomy. Methods A retrospective study was undertaken on all patients who presented with anterior abdominal SW involving combined omental and organ evisceration who underwent laparotomy over a 10-year period from January 2008 to January 2018 at a major trauma centre in South Africa. Results A total of 61 patients were eligible for inclusion and all underwent laparotomy: 87% male, mean age: 29 years. Ninety-two percent (56/61) had a positive laparotomy whilst 8% (5/61) underwent a negative procedure. Of the 56 positive laparotomies, 91% (51/56) were considered therapeutic and 9% (5/56) were non-therapeutic. In addition to omental evisceration, 59% (36/61) had eviscerated small bowel, 28% (17/61) had eviscerated colon and 13% (8/61) had eviscerated stomach. A total of 92 organ injuries were identified. The most commonly injured organs were small bowel, large bowel and stomach. The overall complication rate was 11%. Twelve percent (7/61) required intensive care unit admission. The mean length of hospital stay was 9 days. The overall mortality rate for all 61 patients was 2%. Conclusions The presence of combined omental and organ evisceration following abdominal SW mandates laparotomy. The small bowel, large bowel and stomach were the most commonly injured organs in this setting.

scholarly journals A review of geriatric injuries at a major trauma centre in South Africa

2019 ◽  
Vol 110 (1) ◽  
pp. 44 ◽  
Author(s):  
J-P Da Costa ◽  
J Laing ◽  
V Y Kong ◽  
J L Bruce ◽  
G L Laing ◽  
...  
Keyword(s):  
South Africa ◽  
Major Trauma ◽  
Trauma Centre ◽  
Major Trauma Centre

scholarly journals The spectrum of animal related injuries managed at a major trauma centre in South Africa

2019 ◽  
Vol 57 (3) ◽  
pp. 54-58
Author(s):  
EU Wessels ◽  
VY Kong ◽  
J Buitendag ◽  
S Moffatt ◽  
R Weale ◽  
...  
Keyword(s):  
South Africa ◽  
Major Trauma ◽  
Trauma Centre ◽  
Major Trauma Centre

scholarly journals A review of blunt pelvic injuries at a major trauma centre in South Africa

2021 ◽  
Vol 59 (1) ◽  
Author(s):  
A Ashkal ◽  
VY Kong ◽  
JM Blodgett ◽  
MTD Smith ◽  
W Bekker ◽  
...  
Keyword(s):  
South Africa ◽  
Major Trauma ◽  
Trauma Centre ◽  
Pelvic Injuries ◽  
Major Trauma Centre

1416 Trauma Laparotomy: Experience of a Newly Established Major Trauma Centre in Northern Ireland

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
F Lee ◽  
B Bashabayev ◽  
S Yoong
Keyword(s):  
Northern Ireland ◽  
Royal Victoria Hospital ◽  
Major Trauma ◽  
Trauma Centre ◽  
Trauma Network ◽  
Final Report ◽  
Major Trauma Centre ◽  
The Mean ◽  
One Year ◽  
Mean Time

Abstract Aim The aim of this study was to assess the perioperative pathway and outcomes of trauma laparotomy during a one-year period in a newly established Major Trauma Centre in Northern Ireland. Method Retrospective review of a trauma registry undertaken at the Belfast Royal Victoria Hospital between August 2019 and August 2020. Results During this one-year period, there were a total of 17 trauma laparotomies, with a female-to-male ratio of 6:11, and a mean age of 38.9 years. 15 of 17 cases were due to blunt trauma, with only 2 cases of penetrating trauma. Of trauma laparotomies, 8 were performed during day-time hours (0801-1800), 4 during evening-hours (1801-0000), and 5 during night-time hours (0001-0800). One perioperative death was recorded. The mean time to CT from arrival to ED was 34 minutes (national target of 30 minutes). The mean time until final report was 477 minutes (national target of < 24 hours). The decision to proceed to trauma laparotomy was made prior to the final report in 9 cases. The mean length of inpatient stay for trauma laparotomy patients was 23.3 days, with a mean of 8.9 days spent in critical care. Conclusions This review provides an overview of provision of care for patients who underwent trauma laparotomies in Royal Victoria Hospital MTC and identifies areas for improvement. We plan to prospectively review outcomes following the opening of the Major Trauma Ward on 7th September 2020 and the implementation of the Northern Ireland Major Trauma Network Bypass protocol on 26th October 2020.

scholarly journals An analysis of adverse events and human error associated with the imaging of patients at a major trauma centre in South Africa

2019 ◽  
Vol 109 (9) ◽  
pp. 693 ◽  
Author(s):  
A A Bashir ◽  
V Y Kong ◽  
J J P Buitendag ◽  
V Manchev ◽  
W Bekker ◽  
...  
Keyword(s):  
South Africa ◽  
Adverse Events ◽  
Human Error ◽  
Major Trauma ◽  
Trauma Centre ◽  
Major Trauma Centre

P9 Impact of the relocation of a regional neuroscience service on major trauma patients

2019 ◽  
Vol 90 (3) ◽  
pp. e28.2-e28
Author(s):  
C Cabaret ◽  
M Nelson ◽  
M Foroughi
Keyword(s):  
Major Trauma ◽  
Strong Association ◽  
Trauma Centre ◽  
Trauma Patients ◽  
Major Trauma Centre ◽  
Significant Difference ◽  
Ct Head ◽  
The Mean ◽  
The Impact ◽  
Mean Time

ObjectivesEvaluating the impact of relocating a regional neuroscience service on major trauma patients.DesignRetrospective analysis of prospectively collected data from 01/08/2013 to 31/07/2017.SubjectsPatients≥20 years with a TBI in the 2 years pre-relocation (cohort 1) and 2 years post-relocation (cohort 2).MethodsPatients were identified using the TARN registry. Comparison of the cohorts for demographics, type of neurosurgical input, site of first presentation and the times to first CT head and operation was conducted using cross-tabulation, percentages and statistical analysis (SPSS).Results30% of patients in cohort 1 (112 or 373) were admitted in neurosurgery. This increased to 40% of patients in cohort 2 (181 of 450). There was an increase in admissions for monitoring (70% vs 82%). Patients<60 years had a higher increment in admission (+16 points) than patients≥60 years (+8 points). A strong association was found between the relocation of the neuroscience service and the increase in proportion of patients first transported to the major trauma centre (63% vs 74%; p=0.037). There was a significant decrease in the mean time to operation (3.9 hour vs 2.0 hour; p=0.008) and no significant difference in the mean time to first CT head (1.3 hour vs 1.4 hour; p=0.689).ConclusionsThe relocation of neurosurgery has resulted in a significant increase in admission of patients<60 years with TBI in neurosurgery for monitoring, an increase in the proportion of patients first transported to the MTC and a reduction in the time to operation.

Traumatic renal injury: Five-year experience at a major trauma centre in South Africa

Injury ◽  
2020 ◽  
Vol 51 (1) ◽  
pp. 39-44
Author(s):  
M.S. Salem ◽  
R.J. Urry ◽  
V.Y. Kong ◽  
D.L. Clarke ◽  
J. Bruce ◽  
...  
Keyword(s):  
South Africa ◽  
Renal Injury ◽  
Major Trauma ◽  
Trauma Centre ◽  
Major Trauma Centre
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