scholarly journals Treatment of closed injuries of the liver and spleen

2021 ◽  
Vol 43 (3) ◽  
pp. 27-28
Author(s):  
P. V. Kravchenko ◽  
V. Е. Volkov
Keyword(s):  
Surgical Treatment ◽  
High Mortality ◽  
Abdominal Injuries

Among closed abdominal injuries, liver ruptures are the most severe, surgical treatment of which still gives high mortality (with isolated injuries, according to B.P. Levitsky - 41.7%, A.A.Korolev - 50%, G.F. Nikolaev 15%, SV Lobachev and OI Vinogradova 12.5%), and when combined with damage to other organs, the lethality reaches 50-90%.

scholarly journals Iatrogenic esophageal perforation with mediastinitis, multidisciplinary management: a case report

2021 ◽  
Vol 8 (11) ◽  
pp. 3444
Author(s):  
Juliana Mancera ◽  
Anibal M. Ariza ◽  
Mauricio Pelaez ◽  
Sebastian Benavides ◽  
Alfonso C. Márquez
Keyword(s):  
Surgical Treatment ◽  
High Mortality ◽  
Esophageal Perforation ◽  
Cervical Esophagus ◽  
Superior Mediastinum ◽  
Airway Injury ◽  
Nasojejunal Tube ◽  
Low Incidence ◽  
The Right ◽  
Iatrogenic Esophageal Perforation

Acute mediastinitis is a low incidence pathology, but it is associated with a high mortality rate. Iatrogenic lesions are the most common cause of mediastinitis secondary to esophageal perforation. Early diagnosis and surgical treatment are the most important factors in the treatment of patients with this condition.  83-year-old female patient, with a history of left saphenectomy due to venous insufficiency with difficult intubation two days prior to the emergency consultation. She was admitted to the emergency room due to dyspnea, hemoptysis, chest pain, and right hemifacial edema. A chest tomography was performed with findings suggestive of esophageal perforation or airway injury. Later, in an upper digestive tract study, extravasation of the contrast medium was documented in the right posterolateral wall of the cervical esophagus with a collection in the middle mediastinum. The patient was taken for drainage of mediastinitis by right thoracoscopy and the presence of a perforation in the cervical esophagus was confirmed with an intraoperative endoscopy. Esophageal repair was performed, with drainage of the prevertebral space and the superior mediastinum by a left longitudinal cervicotomy. Postoperatively, she received antibiotic and enteral nutritional support by a nasojejunal tube. Low output fistula of the cervical esophagus, organized by a drain, was documented, which closed after 4 weeks of conservative management. Iatrogenic esophageal perforation with mediastinitis is a very rare entity with a high mortality. Early surgical treatment is the most important prognostic factor in patients with mediastinitis due to esophageal perforation.

scholarly journals Presentation and Immediate Outcome of Surgical Treatment of Patients with Carcinoma of the Stomach - A Comparative Study between Young and Elderly patients

1970 ◽  
Vol 28 (3) ◽  
pp. 145-150 ◽  
Author(s):  
SA Chowdhury ◽  
MM Hussain ◽  
J Ahmed
Keyword(s):  
Surgical Treatment ◽  
High Mortality ◽  
Young Patients ◽  
Partial Gastrectomy ◽  
The Elderly ◽  
Young Group ◽  
Elderly Group ◽  
Similar Proportion ◽  
Mortality And Morbidity ◽  
Carcinoma Of The Stomach

Carcinoma of the stomach is a common malignancy and have a high mortality. Incidence under the age of 45 is comparatively low but appear more aggressive then elderly group. This study was designed to describe the presentation and operative findings in the two groups of patients and to record the outcome of surgical management in these patients.A total of 86 cases were included in this study. 14 were from below 40 years (young group) and 72 were above 40 years (elderly group). Young patients had less definitive symptoms than elderly group. Pain (85.71%) and vomiting (78%) were the most prominent symptoms in both the groups. But in elderly a significant number 54(75%) of cases had anorexia. Lump and visible peristalsis were present in both groups in approximately similar proportion. Histopathologically younger patients had more aggressive disease than the elderly group.The operability in carcinoma of the stomach was more in young group probably due to physical fitness of patient. In both the groups antrum was the commonest site of malignancy. The incidence of malignancy in body was more in young patients. In young group tumor status was T4 in 54.5% and in elderly group 56% was in T4 stage. 80% had lymph node involvement in both the groups. Resection was possible in young group in about 90% and gastrojejunostomy in 9.09% cases. Conversely, in the elderly group resection was possible in 58% and gastrojejunostomy was done in 42% cases. Total gastrectomy was done in 18.18% in young group and 4% in elderly group. Another important finding was partial gastrectomy was done in 72.73% in young but 46% in elderly only. The mortality was more (18.2%) in young group in comparison to (10%) in elderly.Gastric carcinoma was found more aggressive in young with high mortality and morbidity. Efforts should be taken for early diagnosis and prompt surgical treatment. DOI: 10.3329/jbcps.v28i3.6507J Bangladesh Coll Phys Surg 2010; 28: 145-150

scholarly journals Rupture gastrique sur traumatisme fermé de l’abdomen: à propos de 2 cas et revue de la littérature

2019 ◽  
Vol 6 (2) ◽  
pp. 132-135
Author(s):  
Diémé Eugène Gaudens Prosper Amaye ◽  
◽  
Samba Tiapato Faye ◽  
Magatte Faye ◽  
Ibrahima Sall ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Forearm Fracture ◽  
The Other ◽  
Morbidity And Mortality ◽  
Facial Injury ◽  
Abdominal Injuries ◽  
Revue De La Littérature ◽  
Good Outcome ◽  
Gastric Rupture ◽  
Abdominal Lesions

Gastric ruptures in blunt abdominal traumatism is extremely rare accounting for 0.02 to 1.7 % of cases of blunt abdominal injuries. They are frequently associated with other intra- and or extra-abdominal lesions, which generally influence morbidity and mortality. We report two cases of gastric rupture, one with splenic and maxillo-facial injury, the other with forearm fracture, with good outcome after surgical treatment.

scholarly journals Impact of intraoparetive parametres on survival of patients with ruptured abdominal aortic aneurysm

2004 ◽  
Vol 132 (1-2) ◽  
pp. 5-9
Author(s):  
Miroslav Markovic ◽  
Lazar Davidovic ◽  
Zivan Maksimovic ◽  
Dusan Kostic ◽  
Sinisa Pejkic ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Surgical Treatment ◽  
Aortic Aneurysm ◽  
Blood Loss ◽  
High Mortality ◽  
Surgical Procedure ◽  
Ruptured Abdominal Aortic Aneurysm ◽  
Intraoperative Blood Loss ◽  
Lethal Outcome ◽  
Abdominal Aortic

Ruptured abdominal aortic aneurysm is one of the most urgent surgical conditions with high mortality that has not been changed in decades. Between 1991-2001 total number of 1058 patients was operated at the Institute for Cardiovascular Diseases of Clinical Center of Serbia due to abdominal aortic aneurysm. Of this number, 288 patients underwent urgent surgical repair because of ruptured abdominal aortic aneurysm. The aim of this retrospective study was to show results of the early outcome of surgical treatment of patients with ruptured abdominal aortic aneurysm, and to define relevant intraoperative factors that influence their survival. There were 83% male and 17% female patients in the study, mean aged 67 years. Mean duration of surgical procedure was 190 minutes (75-420 min). Most common localization of aneurysm was infrarenal - in 74% of patients, then juxtarenal (12.3%). Suprarenal aneurysm was found in 6.8% of patients, as well as thoracoabdominal aneurysm (6.8%). Retroperitoneal rupture of aortic aneurysm was most common - in 65% of patients, then intraperotineal in 26%. Rare finding such as chronic rupture was found in 3.8%, aortocaval fistula in 3.2% and aorto-duodenal fistula in 0.6% of patients. Mean aortic cross-clamping time was 41.7 minutes (10-150 min). Average intraoperative systolic pressure in patients was 106.5 mmHg (40-160 mmHg). Mean intraoperative blood loss was 3700 ml (1400-8500 ml). Mean intraoperative diuresis was 473 ml (0-2100 ml). Tubular graft was implanted in 53% of patients, aortoiliac bifurcated graft in 32.8%. Aortobifemoral reconstruction was done in 14.2% of patients. These data refer to the patients that survived surgical procedure. Intrahospital mortality that included intraoperative and postoperative deaths was 53.7%. Therefore, 46.3% patients survived surgical treatment and were released from the hospital. Intraoperative mortality was 13.5%. Type of aneurysm had no influence on outcome of patients (p>0.05), as well as type of rupture and level of aortic cross-clamping. Aortic cross-clamping time was significantly shorter in survivors, and longest in patients that died intraoperatively (p<0.05). Intraoperative systolic tension value influenced the outcome in patients; it was significantly higher in survivors (p<0.01). Interposition of tubular graft gave better results compared with aorto-iliac and aorto-femoral reconstruction (p<0.01). Duration of surgery was significantly higher in patients with lethal outcome (p<0.05), as well as intraoperative blood loss (p<0.05). Intraoperative diuresis was significantly lower in patients with lethal outcome (p<0.05). Ruptured abdominal aortic aneurysm still remains one of the most dramatic surgical states with very high mortality. Important intraoperative factors that influence the outcome of surgical treatment can be defined. Therapeutic efforts should be concentrated on those factors that are possible to correct, which would hopefully lead to better survival of patients. Nevertheless, screening for abdominal aortic aneurysm and elective surgical intervention before rupture occurs should be the best solution for this complex problem.

scholarly journals Open pelvic fractures - results of an multi-institutional study

2021 ◽  
pp. 65-65
Author(s):  
Marko Mladenovic ◽  
Predrag Stoiljkovic ◽  
Ivica Lalic ◽  
Vladimir Harhaji ◽  
Andrija Krstic
Keyword(s):  
High Mortality ◽  
Pelvic Ring ◽  
Hypovolemic Shock ◽  
Colon Resection ◽  
Pelvic Fractures ◽  
Type I ◽  
Vertical Force ◽  
Abdominal Injuries ◽  
Mortality Factors ◽  
Pelvic Ring Fractures

Open pelvic fractures are devastating injuries, rare, and with high mortality. Leading causes of mortality are: haemorrhage, infection and associated injuries. The aim of this paper is to point out methods of treating these injuries and great number of prognostic mortality factors. Material - in period from January 2011 to December 2015, 221 patients with pelvis ringfracture were treated in three large clinical centers of Serbia, of which 13(5%) had an open fracture type. We have classified pelvic ring fractures according to the Young - Burgess classification. We have classified injuries according to Gustilo at I, II, and III degree, and the location of the wound according to Faringer classification was distributed in zone I, II and III. Urogenital and intra-abdominal injuries were monitored, and severity of injuries was determined according to Severity Score Injury (ISS) and Trauma Score (TS). Results - there were 6(46%) women and 7(54%) men at the average age of 41(13 - 76). Injuries from traffic trauma are dominant. The most common cause of pelvic ring fracture is an anterior posterior compression - 6(46%), lateral compression - 4(31%) and vertical force in 3 (23%) patients. Dominant injuries are type I and II according to Gustilo, and zone I according to Faringer classification. There were 6 (46%) patients with urogenital injuries, and the same number with intra-abdominal injuries, of which 3(23%) patients have been treated with colon resection and diversion. Due to abundant hemorrhage and hypovolemic shock 2 patients died, and another one died after three days due to sepsis and multisystem organ failure (MSOF). Conclusion - Open pelvic fractures have high mortality rate, due to: haemorrhage, infection, associated abdominal and genitourinary tract injuries, ISS> 25, TS <8 and age of patient >65 years.

Surgical treatment of high-lying rectal neoplasms

1934 ◽  
Vol 30 (2) ◽  
pp. 189-189
Author(s):  
Ya. M. Iofan ◽  
A. A. Kudryavtsev
Keyword(s):  
Colon Cancer ◽  
Surgical Treatment ◽  
Mortality Rate ◽  
High Mortality ◽  
Rectal Neoplasms ◽  
The West ◽  
Surgical Interventions ◽  
Statistical Record

Currently, the dominant surgical interventions for high-lying rectal neoplasms are intraperitoneal and sacral methods. The latter methods, which are well established, have a great statistical record both in our Union and among surgeons in the West and America. However, we cannot say that we are completely satisfied with these methods: peritoneal-sacral method has a high mortality rate (47%), sacral method has less mortality but is also not without shadows. In the following lines we intend to describe the method applied by us on May 5, 1933, in case of high colon cancer of the patient M. Shchetinina, 39 years old.

Pleural infection

2007 ◽  
pp. 153-160
Keyword(s):  
Surgical Treatment ◽  
Pleural Effusion ◽  
Thoracic Surgery ◽  
High Mortality ◽  
Early Recognition ◽  
Bacterial Invasion ◽  
Subsequent Infection ◽  
Prompt Treatment ◽  
Acute Presentation ◽  
Pleural Infection

Introduction 154 Definitions 154 Pathophysiology 154 Acute presentation 155 Investigations 155 Management 158 A pleural effusion occurs in up to 40% of cases of pneumonia. The majority of these will resolve with treatment of the pneumonia, but a subset will undergo bacterial invasion and subsequent infection will be established. This condition has a high mortality (20%) and morbidity, with 20% of cases requiring invasive thoracic surgery. Early recognition and prompt treatment is important to prevent progression to disease only amenable to surgical treatment....

scholarly journals Early Clinical Diagnosis and Treatment of Traumatic Aortic Injury Caused by Thoracic and Abdominal Injuries: A Series of Four Cases with Literature Review

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Qiqi Wu ◽  
Shanshan Sun ◽  
Jie Xie ◽  
Tianyu Li ◽  
Hui Li ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Early Diagnosis ◽  
Aortic Dissection ◽  
Clinical Manifestations ◽  
Intramural Hematoma ◽  
Aortic Injury ◽  
Trauma Patients ◽  
Abdominal Injuries ◽  
Thoracic And Abdominal ◽  
Thoracic And Abdominal Injuries

Aortic injury, particularly traumatic aortic dissection caused by thoracic and abdominal injuries, is extremely rare. The diagnosis rate of blunt aortic injury caused by chest and abdominal injuries is often low, and its clinical manifestations are atypical. Once missed or misdiagnosed, the consequences are serious. Early diagnosis of traumatic aortic injury in complex thoracic and abdominal injuries is a key factor in reducing the mortality of trauma patients. Among all trauma patients treated in our department from December 2018 to December 2020, we diagnosed four cases of aortic injury, including three cases of aortic dissection and one case of intramural hematoma. Successful surgical treatment and clinical outcome were achieved in all four patients. We found that early diagnosis and surgical treatment can help to reduce the mortality of patients with traumatic aortic injury and improve the prognosis.

scholarly journals SUCCESSFUL TREATMENT OF INJURIED SPLEEN COMPLICATED BY A GIANT POST-TRAUMATIC CYST

2019 ◽  
Vol 23 (4) ◽  
pp. 211-214
Author(s):  
G. N. Rumyantseva ◽  
S. I. Volkov ◽  
A. A. Yusufov ◽  
Alexander N. Kazakov ◽  
Yu. F. Brevdo ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Successful Treatment ◽  
Abdominal Injuries ◽  
Frequent Complication ◽  
Post Traumatic ◽  
Organ Sparing ◽  
A Priority ◽  
Non Surgical Treatment

In case of blunt abdominal injuries in children, the spleen is involved most often. The organ-sparing tactics - if there are specific indications is a priority in managing spleen injuries. Post-traumatic cysts is the most frequent complication of non-surgical treatment of the spleen. How to treat such cysts is still a disputable issue.

scholarly journals Современные технологии диагностики и лечения травм поджелудочной железы

2021 ◽  
Vol 14 (3) ◽  
Author(s):  
F Khadjibaev ◽  
Sh Atadjanov ◽  
K Rizaev ◽  
A Mustafaev ◽  
A Askarov
Keyword(s):  
Computed Tomography ◽  
Surgical Treatment ◽  
Magnetic Resonance ◽  
Ultrasound Examination ◽  
Clinical Signs ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Clinical Problem ◽  
Abdominal Injuries ◽  
Pancreatic Trauma ◽  
Initial Symptoms

Pancreatic trauma is rare from 0.2% to 12% of abdominal injuries, but presents a complex clinical problem due to the erased initial symptoms and the absence of specific clinical signs, which lead to late diagnosis and delay surgical treatment. The symptoms of pancreatic trauma are nonspecific and often masked by trauma to other organs. In this regard, this article separately considers the issues of radiation diagnostics (ultrasound examination, multispiral computed tomography, magnetic resonance cholangiopancreatography, retrograde cholangiopancreatography, laparoscopy) and the choice of tactics for the treatment of рancreatic trauma.

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