Skip to main navigation menu Skip to main content Skip to site footer

Abdominal vascular trauma: type of vascular injuries Hospital de Kennedy 2002-2007

Trauma vascular abdominal: tipo de lesiones vasculares hospital de Kennedy 2002-2007




Section
Research Article

How to Cite
Ríos, G., & Ramírez, M. (2012). Abdominal vascular trauma: type of vascular injuries Hospital de Kennedy 2002-2007. Journal of Medicine and Surgery Repertoire, 21(2), 115-121. https://doi.org/10.31260/RepertMedCir.v21.n2.2012.805

Dimensions
PlumX
license

   

Giovanny Ríos
    Miguel Ramírez

      Introduction: abdominal vascular injuries are highly difficult and challenging. They feature the lethal vicious cycle of shock, acidosis, hypothermia, hypocoagulability and heart arrhythmias. This study's objective is to describe the frequency and epidemiologic characteristics of cases handled at Hospital Occidente de Kennedy during the last 5 years. Materials and Methods: review of 150 clinical records of patients seen between January 2002 and December 2007 with main diagnosis of abdominal vascular trauma. Those in which study variables were not adequately recor­ ded were excluded. Results: men were mostly affected (85.3%) and average age was 28.9 years. The most common identification method was acute abdomen (112 cases, 74.6%). The most frequent trauma mechanism was penetra­ ting trauma by a gunshot wound (80 cases, 53.3%). The most frequent injuries were classified as grade III (86) and associated intra-abdominal organ injured was small intestine (28, 18.6%). Ali patients underwent a laparotomy and thoracotomy was performed in 22 (15%). Primary suture was the most used repair method (104, 69.3%). Sepsis was the main complication (14, 9.3%). Mortality rate was 42.6% (60 cases). Injuries most frequently associated with mortality involved the infrarenal and retrohepatic aorta, vena cava and portal, mesentheric and iliac vessels. Death was due to intra-abdominal sepsis in 6 patients. Clinical recovery: 86 patients survived; out of 20 cases with an open abdomen, ten (6.6 %) progressed positively and incisional hernia repair with mesh graft was performed subsequently; 46 recovered in the immediate postoperative period and experienced early dismissal (type 1-11). Complications in the remaining patients were managed with amputation in 4 cases, and bowel fistula and antibiotics for infected wounds. Conclusions: an adequate approach and control of vascular injuries allows management with simple procedures such as a lateral suture. The three major vessel injuries associated to high mortality rate involve the aorta, vena cava and portal vein. Ischemia, injury mechanisms, associated impairments, chronic vascular disease and clinical findings must be considered to determine prognosis.


      Article visits 730 | PDF visits 1813


      Downloads

      Download data is not yet available.

      1. Agarwal N, Shah PM, Clauss RH, el al. Experience with 115 civilians venous injures. J Trauma 22. 1982;827-32.
      2. Ascencio, J, Demetriades D, Feliciano D, Hoyt D. Traumatismo vascular: le­ siones complejas y desafiantes, Parte l. Clínicas Quirúrgicas de Norteamérica. 1/2002;81(6).
      3. Brunet P. Actualización en el tratamiento del traumatismo vascular. Rev Cubana. 1999;28(2).
      4. García E. Traumatismo vascular abdominal. Hospital Universitario. Martín Chang puga Ag, 2008, www.sld.cu/galerias/pptlsitioslcentromedltrauma_vascu­ lar_abdominal.ppt
      5. www.sld.cu/galerias/pptlsitioslcentromedltrauma_vascular_abdominal.ppt
      6. Feliciano IA, Byrd WM, and McAfee DK. Experiences in lhe management of arterial injuries. Ann Surg. 1961;153:980-6.
      7. Ascencio J, Demetriades D, Feliciano D, Hoyt D. Traumatismo vascular: le­ siones complejas y desafiantes, Parte 2. Clínicas Quirúrgicas de Norteamérica. 1/2002;8 l (6).
      8. DeBakey ME, Simeone FA. Battle injures of the arteries in World War 11: An analysis of 2471 cases. Ann Surg. 1946;123:534-79.
      9. Hughes CW. Arterial repair during lhe Korean War. Ann Surg. 1958;147:555-61.
      10. Rodríguez A, Ferrada R. Trauma vascular abdominal. Sociedad Panamericana de Trauma. Trauma. 1997;411-27.
      11. Rich NM, Baugh JH, Hughes CW. Acute arterial injuries in Vietnam: 1000 Cas­ es. J Trauma. 1970;10:359-69.
      12. Demetriades D, Theodorou D, Murray J, et al. Mortality and prognostic factors in penetrating injuries of the aorta. J Trauma. l996;40:761-3.
      13. Guzmán Mora F, Ríos G. Guías para manejo de urgencias. Fundación Santa Fe de Bogotá. Capítulo XXX. 2002.
      14. Morales C, Sanabria A, Sie1rn J. Traumatismos vasculares en Colombia, Experi­ encia de un centro de traumatología de primer nivel en Medellín, Departamento de Cirugía, Universidad de Antioquia, Clínicas Quirúrgicas de Norteamérica, Traumatismo Vascular, Parte 11, l/2002;189-204.
      15. Londoño E, Ospina JA, De la Hoz J. Heridas de la vena cava. Rev. Colombiana de Cirugía. 1988;3:17-21.
      16. Mattox KL, Feliciano. DV, Burch J, Beall AC Jr, Jordan GL Jr, De. Bakey ME. Five thousand seven hundred sixty cardiovascular injuries in 4459 patients. Epi­ demiologic evolution 1958 to 1987. Ann Surg. 1989 Jun;209(6):698-705; discus­ sion 706-7.
      17. E. Viver Manresa, E. Ros Die. Traumatismos arteriales. Patología Vascular. 1993;191-209.
      18. Rutherford R, Vascular Trauma. Vascular Surgery. Sixth edition. Elsevier Saun­ ders. 2005;1001-76.
      19. Khalil IM, Livingston DH. lntravascular shunts in complex lower limb trauma. J Vasc Surg. 1986;4:582-7.
      20. Hoyt DB, Coimbra R, Potenza BM, Rappold JF. Anatomic exposures far vascu­ lar injuries. Surg Clin North Am. 2001 Dec;81(6):1299-330, xii.

      Sistema OJS 3.4.0.5 - Metabiblioteca |