scholarly journals Unusual Post-Traumatic Under-Serosa Rupture of the Gallbladder

2021 ◽  
pp. 1-3
Author(s):  
Guizani Rami ◽  
Guizani Rami ◽  
Rebii Saber ◽  
Hajri Mohamed ◽  
Zenaidi Hakim ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Abdominal Trauma ◽  
Road Accident ◽  
Abdominal Injury ◽  
Postoperative Course ◽  
Blunt Abdominal Injury ◽  
Public Road ◽  
Post Traumatic ◽  
Distended Gallbladder

Gallbladder lesions due to blunt abdominal injury are rare, being found in only about 2% of patients who undergo laparotomy for abdominal trauma. It is commonly associated with other concomitant visceral injuries. It is challenging to make an early diagnosis. We report the case of a 35-year-old woman victim of a public road accident who underwent laparotomic cholecystectomy. Acute post traumatic cholecystitis was suspected based on clinical and radiologic data. Perioperative findings showed no ascites, but a distended gallbladder. Its serosa was intact. After its removal, we opened the gallbladder, we discovered a rupture of the mucosa and bile trapped between the mucosa and the serosa of the gallbladder. The postoperative course was simple.

scholarly journals Isolated gallbladder perforation in paediatric blunt abdominal injury: A case report and review of literature

2021 ◽  
Vol 7 (2) ◽  
pp. 103-107
Author(s):  
Sujoy Neogi ◽  
Arka Banerjee ◽  
Shasanka S Panda ◽  
Simmi K Ratan
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Diagnostic Laparoscopy ◽  
Road Accident ◽  
Organ Injury ◽  
Current Evidence ◽  
Gallbladder Perforation ◽  
Free Fluid ◽  
Solid Organ ◽  
Blunt Abdominal Injury

Gallbladder injury in blunt abdominal trauma is rare, around 2% of all abdominal traumas. Vague symptoms and inconclusive imaging make it an elusive diagnosis, more so in children. Only 30 pediatric cases have been reported worldwide till date. We report a case of a 7yrs old boy presenting 2 weeks after a road accident with a gallbladder rupture which was eventually discovered on a diagnostic laparoscopy. This is the second such case being reported from India. The injury is most often identified at exploration and although cholecystectomy is the preferred treatment, there are occasions when the gallbladder may be left in situ. The classification system of Losanoff and Kjossev has merit in guiding treatment. The various presentations, mechanisms and modes of injury have been highlighted along with the clinical and imaging findings. Despite the developments in modern radiology, identifying gallbladder perforation has always been difficult because of the rarity of the condition. In a child with blunt abdominal trauma and intra-abdominal free fluid without any solid organ injury, a diagnostic peritoneal tap may be helpful. Based on the current evidence, we advocate a low threshold for performing a diagnostic laparoscopy in all such cases.

scholarly journals A Review of Posttraumatic Bowel Injuries in Ibadan

ISRN Surgery ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
A. E. Dongo ◽  
E. B. Kesieme ◽  
D. O. Irabor ◽  
J. K. Ladipo
Keyword(s):  
Abdominal Trauma ◽  
Developed Countries ◽  
Bowel Injury ◽  
Abdominal Injury ◽  
Surgical Operation ◽  
Diagnostic Challenge ◽  
Simple Closure ◽  
Blunt Abdominal Injury ◽  
Penetrating Abdominal Injury ◽  
Ibadan Nigeria

Background. Bowel injuries are a leading cause of morbidity and mortality following trauma. Evaluating patients who sustained abdominal trauma with bowel injury may pose a significant diagnostic challenge to the surgeon. Prompt recognition and timely intervention is necessary to improve outcome. Aim. This study was undertaken to evaluate treatment and outcome of patients with bowel trauma. Methods. A 5-year retrospective study of all patients presenting with abdominal trauma requiring surgical intervention seen in the UCH Ibadan, Nigeria was undertaken. Results. There were 71 patients (59 males and 12 females). The majority of cases (70%) occurred between the 3rd and 5th decades of life. Some 37 patients (52%) sustained blunt abdominal injury, while 34 patients (48%) sustained penetrating abdominal injury. There were 27 patients with bowel injuries (38%). Isolated bowel injuries occurred in 19 patients (27%). The most common surgical operation performed was simple closure. There were 3 deaths in patients with bowel injuries. Conclusion. Most cases of bowel injury can be managed by simple closure, a technique that is not so technically demanding for surgeons in less-developed countries. This study has also incidentally identified a “rule of six” for patients with bowel injuries and abdominal trauma.

scholarly journals Computed Tomography Evaluation of Blunt Abdominal Injury

2020 ◽  
Vol 8 (2) ◽  
pp. 57-60
Author(s):  
Sholy K Vareed ◽  
Don Paul Mathew ◽  
Justine Antony
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Abdominal Trauma ◽  
Road Traffic ◽  
Abdominal Injury ◽  
Blunt Abdominal Injury ◽  
Iodinated Contrast ◽  
Abdomen Ct ◽  
Number Of Patients ◽  
Grade Ii

Background: Unlike penetrating abdominal trauma, where management is largely determined clinically, the diagnosis of blunt abdominal injury by clinical examination is unreliable, particularly in patients with a decreased level of consciousness.Plain abdominal radiography has limited role in the assessment of blunt abdominal trauma, although some authorities continue to advocate its use. CT scan’s main advantage is the ability to detect arterial contrast extravasation, uncontained or as a pseudoaneurysm, which predicts the need for surgery or angioembolisation. The aim is to study computed tomography evaluation of blunt abdominal injury. Subjects and Methods: The present study was conducted in the Department of Radiology of the medical institution. For the study, we used abdomen CT scan reports of 100 patients with BAT, who were stable enough to undergo radiological investigation. The patients included 66 males and 34 females. All CT scans were obtained with a 16 slice MDCT Scanner (Siemens). All patients received intravenous bolus of iodinated contrast agents. Individual organ injuries were graded according to the American Association for the Surgery of Trauma (AAST - OIS) injury scoring scale. The overall imaging findings were analysed for their role in guiding the therapeutic options, whether conservative or surgical. Results: Total number of patients included in the study was 100. The mean age of patients was 41.97 years. Number of male patients was 66 and number of female patients was 34. For the mode of injury, other miscellaneous causes were most common in out study group followed by road traffic accidents. It was observed that OIS grade II patients were 19, OIS grade III patients were 29, OIS grade IV patients were 12 and OIS grade V patients were 10. The highest proportion of conservatively managed patients were seen in OIS grade II patients. Conclusion: Within the limitations of the present study, it can be concluded that CT scan for blunt abdominal injury is a reliable and accurate method for diagnosis. It has all the qualities to make it a gold standard for initial investigation of choice for blunt abdominal injury patients.

scholarly journals Condition of the gastrointestinal tract motor function in abdominal injury

2019 ◽  
Keyword(s):  
Gastrointestinal Tract ◽  
Motor Function ◽  
Abdominal Trauma ◽  
Abdominal Injury ◽  
Main Criterion ◽  
Functional Compensation ◽  
Moderate Severity ◽  
Blunt Abdominal Injury ◽  
Severity Of Injury ◽  
Instrumental Methods

Introduction. Injuries are a large medical and social problem. It takes many lives and is often a cause of disability. Objectives. The work is devoted to the study of the motor-evacuation function (MEF) of the gastrointestinal tract (GIT) in patients with closed abdominal injury of varying severity. Materials and methods. 125 patients with isolated or combined blunt abdominal trauma were under observation. The main criterion for the inclusion of patients in the study was the presence of injury to the abdomen and / or retroperitoneal space, confirmed while surgery or using instrumental methods of examination. The structure of injuries was dominated by a combined trauma, which was observed in 104 (83.2%) victims; in 21 (16.8%) patients abdominal injury was isolated or multiple. Evaluation of the MEF of the gastrointestinal tract was carried out using a technique developed with the participation of the author on the basis of the available indicators widely used in practice. The severity of the injury was determined on an ISS scale. Results. The results showed that the predominant part of patients with abdominal trauma (62.4%) had a violation of gastrointestinal MEF upon admission; in 21% of patients, the state of function at the border of functional compensation was noted, and only in 16% of persons, the MEF of the gastrointestinal tract was rated as moderately and completely compensated. By severity of injury, a group of patients with moderate severity (47.2%) prevailed; a mild injury was observed in 35.2% of patients, severe injury was diagnosed in 16%, and a super-severe one was in 1.6% of injured people. Conclusions. The possibility of using the MEF indicators of the gastrointestinal tract as one of diagnostic criteria for the severity of a blunt abdominal injury is assumed.

scholarly journals Post - Traumatic Hip with Obtu rator Dislocation: Case Report a nd Review of t he Literature

2018 ◽  
Vol 2 (3) ◽  
pp. 1-3
Author(s):  
Mehdi Omar Krimech
Keyword(s):  
Femoral Head ◽  
External Rotation ◽  
Road Accident ◽  
Aseptic Necrosis ◽  
The Public ◽  
Public Road ◽  
Post Traumatic ◽  
The Stability

Introduction: Traumatic dislocation of the coxofemoral joint is defined as the permanent posterior or anterior displacement of the femoral head out of the acetabular cavity. It is generally the consequence of a violent trauma, most often an accident on the public road. o ur case it is a post - traumatic hip obtu rator dislocation, managed in our department. Clinical case and results: 16 years old patient, with no particular history, victim of a road accident, causing a closed trauma to his left hip, right ankle and left wrist. It presents with a vicious attitude: left lower limb in flexion, abductio n, external rotation. An X - ray reques ted objective obturator dislocation with a small bone fragment of the head. A bone reconstruction CT was completed in favour of obturator dislocation with head fracture type 1 according to Pipkin's classification. Patient sent directly to the block, he ben efits from a reduction under sedation according to Boehler's maneuver, control by scopy, then immoblisation by zimmer splint after testing the stability of dislocation. Patient is hospitalized in our ward for monitoring then follow - up in consultation. Resu lts were satisfactory, removal of the zimmer splint at the 6th week. Total support was possible at week 12, with complete mobility, patient reviewed afterworld without clinico - radiological signs of aseptic necrosis of the femoral - head. Conclusion: The frac ture - luxation of the femoral head is a serious lesion. It is necessary to think about it in front of each dislocation not to ignore the associated fracture which still darkens the prognosis.

scholarly journals Analytical revisit to basics helps reduce unnecessary CT scan in children with abdominal trauma: A single institution experience

2018 ◽  
Vol 6 (2) ◽  
pp. 54-62
Author(s):  
Rizwan A. Khan ◽  
Mohd Hazique ◽  
Shagufta Wahab
Keyword(s):  
Ct Scan ◽  
Abdominal Trauma ◽  
Clinical Laboratory ◽  
Final Diagnosis ◽  
Abdominal Injury ◽  
Free Fluid ◽  
Abdominal Injuries ◽  
Blunt Abdominal Injury ◽  
Line Imaging ◽  
Sensitive Parameters

Introduction. CT scan is regarded as the investigation choice for accurate depiction of blunt abdominal injuries in children and is considered as an inevitable tool in the armamentarium of the clinician before deciding for conservative management of these children. However over dependence on CT scan puts the patient to many disadvantages. The aim of this study to devise stratification criteria for the children with blunt abdominal injury and advise CT scan to the children only who really require it. Material and methods. All the children with blunt abdominal injury were studied prospectively over a period of two years. These children underwent clinical, biochemical and ultrasonographic assessment at presentation followed by CT abdomen. Efficacy of predefined clinical, biochemical and ultrasonographic parameters was compared with CT scan to triage the children with intra abdominal injury. Results. A total of 84 children were registered in the study based on final diagnosis of presence or absence of intra abdominal injury the children were divided in two groups. These groups were then compared for various clinical, laboratory and ultrasonographic parameters to predict intra abdominal injury. The children having isolated abdominal injury, tenderness, raised AST, ALT and amylase and free fluid on ultrasonography were found to have more chances of intrabdominal injury (p < 0.001). These parameters were the most sensitive parameters to predict intra abdominal injury and the cumulative sensitivity of these parameters was 99.7%. The CT abdomen was negative in 74.7% of the patients. Conclusion. Due to high negative rate of CT abdomen in children with abdominal trauma, its use as first line imaging investigation is questionable in all the children with abdominal trauma. We suggest that by utilizing clinical, biochemical and ultrasonographic parameters, the children at risk of intra abdominal injuries can identified with almost 100% accuracy mandating the use of CT scan only in these children.

scholarly journals Subtle Radiological Features of Splenic Avulsion following Abdominal Trauma

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
S. A. Rehim ◽  
H. Dagash ◽  
P. P. Godbole ◽  
A. Raghavan ◽  
G. V. Murthi
Keyword(s):  
Abdominal Trauma ◽  
Nonoperative Management ◽  
Abdominal Injury ◽  
Ct Scans ◽  
Emergency Laparotomy ◽  
Splenic Trauma ◽  
Avulsion Injury ◽  
Operating Team ◽  
Radiological Features ◽  
Blunt Abdominal Injury

Splenic trauma in children following blunt abdominal injury is usually treated by nonoperative management (NOM). Splenectomy following abdominal trauma is rare in children. NOM is successful as in the majority of instances the injury to the spleen is contained within its capsule or a localised haematoma. Rarely, the spleen may suffer from an avulsion injury that causes severe uncontrollable bleeding and necessitates an emergency laparotomy and splenectomy. We report two cases of children requiring splenectomy following severe blunt abdominal injury. In both instances emergency laparotomy was undertaken for uncontrollable bleeding despite resuscitation. The operating team was unaware of the precise source of bleeding preoperatively. Retrospective review of the computed tomography (CT) scans revealed subtle radiological features that indicate splenic avulsion. We wish to highlight these radiological features of splenic avulsion as they can help to focus management decisions regarding the need/timing for a laparotomy following blunt abdominal trauma in children.

scholarly journals Hepatic Trauma Interventions

2021 ◽  
Vol 38 (01) ◽  
pp. 096-0104
Author(s):  
Akshita S. Pillai ◽  
Girish Kumar ◽  
Anil K. Pillai
Keyword(s):  
Liver Injury ◽  
Cause Of Death ◽  
Abdominal Trauma ◽  
Penetrating Trauma ◽  
Liver Trauma ◽  
Solid Organ ◽  
Hepatic Trauma ◽  
Blunt Abdominal Injury ◽  
Large Size ◽  
Uncontrolled Bleeding

AbstractThe liver is the second most commonly involved solid organ (after spleen) to be injured in blunt abdominal trauma, but liver injury is the most common cause of death in such trauma. In patients with significant blunt abdominal injury, the liver is involved approximately 35 to 45% of the time. Its large size also makes it a vulnerable organ, commonly injured in penetrating trauma. Other than its position and size, the liver is surrounded by fragile parenchyma and its location under the diaphragm makes it vulnerable to shear forces during deceleration injuries. The liver is also a vascular organ made of large, thin-walled vessels with high blood flow. In severe hepatic trauma, hemorrhage is a common complication and uncontrolled bleeding is usually fatal. In fact, in patients with severe abdominal trauma, liver injury is the primary cause of death. This article reviews the clinical presentation of patients with liver injury, the grading system for such injuries that is most frequently used, and management of the patient with liver trauma.

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