By Harry M. Delany M.D., F.A.C.S., Robert S. Jason M.D. (auth.)
Trauma to the stomach, either unintentional and willful, has develop into more and more universal during this period of accelerating violence. huge numbers of sufferers everywhere in the nation are admitted to emergency rooms due to belly trauma of various levels of severity. All too frequently the proper analysis is suspected belatedly or under no circumstances, in order that right therapy isn't really initiated in enough time to be lifesaving. now not infre quently, the injured sufferer is tested by means of an intern or an insufficiently skilled resident healthcare professional. Even in cases the place extra senior internists and surgeons can be found, distinctive wisdom in regards to the invaluable technique to set up the proper analysis and institute the proper remedy is missing. This monograph, representing the felicitous collaboration of a health care professional and a radiolo gist including numerous different participants, is well timed and significant. The authors (and their participants) have approached their topic with a wealth of scientific experi ence received in different very energetic acute-care municipal hospitals within the greatest urban during this nation. they've got saw and taken care of a really huge variety of sufferers with a large number of hectic motives, together with firearm accidents, stab wounds, vehicular injuries, falls, and attacks. The authors have divided this paintings into 4 major sections: basic views on stomach damage, sorts of belly accidents, particular Diagnostic suggestions, and particular Organ or Supporting-Structure Injury.
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Extra resources for Abdominal Trauma: Surgical and Radiologic Diagnosis
Roentgenographic Evaluation by Stab-Wound Contrast Injection The use of direct contrast injection under radiologic control to study penetrating abdominal wounds was introduced by Cornell et al. in 1965 . To perform this examination, a catheter is snugly fitted into the penetrating abdominal wound and secured to the wound edges by surgical suture material; 50-60 cc of urographic water-soluble contrast material is then injected under pressure through the catheter and into the wound. Penetrating injury to the abdominal cavity can be demonstrated by the intraperitoneal spread of contrast to outline loops of bowel and other abdominal viscera.
Snyder CJ (1972) Bowel injuries from automobile seat belts. Am J Surg 123: 312-316 42. Steichen FM, Efron G, Pearlman OM, Weil PH (1969) Radiographic diagnosis versus selective management in penetrating wounds of the abdomen. Ann Surg 170(6): 978-983 43. Stimson LA (1889) NY Med J Quoted by Coley  44. Strauch GO (1973) Major abdominal trauma in 1971. A study of Connecticut by the Connecticut Society of American Board Surgeons and the Yale Trauma Program. Am J Surg 125: 413-418 45. Taylor FW (1973) Gunshot wounds of the abdomen.
The (E) arterial phase from a flush aortogram reveals a large avascular LUQ mass that is producing rightward displacement of the proximal abdominal aorta and inferior displacement of the splenic artery (curved solid arrow), left renal artery (curved open arrow), and left kidney. The (F) arterial and (G) venous phases from a selective splenic angiogram reveal a large, avascular, intrasplenic mass with inferior compression of the remaining normal splenic tissue. At exploration, a large spleen weighing 1400 g and measuring 15 x 16 x 15 cm was found.