Stomach Injury in Multiple and Polytrauma

Mustafakulov I. B. MD.^1,

¹Samarkand State Medical Institute, Surgery department of RSCUMA, Samarkand, Uzbekistan

Cite this paper

Mustafakulov I. B. MD.. Stomach Injury in Multiple and Polytrauma. American Journal of Medical Case Reports. 2014; 2(7):133-135. doi: 10.12691/AJMCR-2-7-1

Abstract

Stomach injury is one of the most severe types of injuries and among severe injuries of piece abdominal injuries makes 25%. Post traumatic stomach ruptures make 1% of abdominal injuries in isolated abdominal traumas and up to 6% in combined. During 1999-2012 periods we have analyzed 57 observations, of them 12 isolated and 45 combined gastric injuries. Injuries of anterior gastric wall were revealed in 42 patients, of posterior wall in 4 persons with thoracoabdominal wounds and of both walls in 11 patients. Study proved some different surgical treatment tactics of stomach injury have been presented. Complications in the postoperative period developed in 9 (15, 8%) patients with ruptures in all layers of the stomach. Relaparatomy became necessary in 5 patients due to the following indications: ileus (2), pancreatitis (1), bleeding to gastric lumen (1) insolvency of stomach wound sutures. 3 of 5 reoperative patients died, all of them had combined traumas; 2 mortality of shock and blood loss, 1 from pancreatitis and peritonitis. An adequate intervention volume in gastric injuries appears to be two-layer suturing of the wound with previous ligating of bleeding vessels and following decompression of the organ through nasogastral probe.

Keywords

stomach injury, different surgical treatment

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Urman M.G. Trauma of the stomach. Perm, 2003, p. 258.
[2]	Michel Ph. Rupture gastrique post-traumatique//J. Chir. 1987. Vol. 124, № 2, P. 138-139.
[3]	Anishin N.S. and et.al. Closure of gastric damage in blunt trauma of the upper abdominal part. Bulletin of surgery, 1986, № 3. p. 67-69.
[4]	Agadjanjan V.V. Polytrauma. – Novosibirsk. Science, 2003. p. 483.
[5]	Abakumov M.M. end et.al. Injury of the abdomen in combined trama// М., Мед., 2005.
[6]	Gorshkov S.Z. Kozlov I.Z., Volkov V.S. Closure of gastric injury // Sov. Medicine, 1978, № 9. p. 135-138.
[7]	Abakumov M.M et.al. Combined injuries of the chest // the firs congress of Moscow Surgeons. Emergency and Specialized Surgical Aid. Thesis of reports. М., 2005. p. 202-203.
[8]	Zhang M., Liu Z.H., Yang J.X., et al. Rapid detection of pneumothorax by ultrasonography in patients with multiple trauma // Crit. Care. 2006. 10(4). P. 112.
[9]	Gorshkov S.Z. and et. al. Closed injuries of the stomach// Sov. Medicine,- 1978,- № 9.- p. 135-138.
[10]	Shaposhnikov J and et. al. Stomach injuries, М.: Меdicine 1986, p. 55.
[11]	Durham R.M., Moran J.J., Mazuski J.E. et al. Multiple organ failure in trauma patients // J. Trauma. 2003. Oct. 55(4): 608-16.
[12]	Fennerty M.B. Pathophysiology of the upper gastrointestinal tract in the critically ill patient: Ratijnale for therapeutic benefits of acid suppression // Crit. Care. Med. 2002. № 30. P. 351-355.
[13]	Holte K., Kehlet H. Postoperative ileus: progress towards effective management // Drugs. 2002. 62: 2603-15.
[14]	Michel Ph. Rupture gastrique post-traumatique//J. Chir. 1987. Vol. 124, № 2, P. 138-139.
[15]	Finkielman J.D., Gajic O., Farmer J.C. et al. The initial Mayo Clinic experience using high-frequency oscillatory ventilation for adult patients: a retrospective study // BMC Emerg. Med. 2006. – Vol. 6. № 1. P. 2.
[16]	Eryuhin I.A. et al. Organization and volume of surgical aid the wounded. // Experience of medical provision for troops in Afghanistan, 1979-1989 M. Named after acad. N.N. Burdenko, 2002. 400 p.
[17]	Rozanov V.E. Palchikov A.A. Small volume resuscitation in severe combined trauma // Thesis of Х all Russia Conf. “actual questions of anesthesiology and resuscitation CP, 2003, P. 117-118.