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Prise en charge des traumatismes pénétrants de l’abdomen : des spécificités à connaître

Authors :
B. Lenoir
B. Debien
F. Pons
M. Planchet
N. Cazes
E. Falzone
Thomas Leclerc
Y. Goudard
Clément Hoffmann
Source :
Annales Françaises d'Anesthésie et de Réanimation. 32:104-111
Publication Year :
2013
Publisher :
Elsevier BV, 2013.

Abstract

Penetrating traumas are rare in France and mainly due to stabbing. Knives are less lethal than firearms. The initial clinical assessment is the cornerstone of hospital care. It remains a priority and can quickly lead to a surgical treatment first. Urgent surgical indications are hemorrhagic shock, evisceration and peritonitis. Dying patients should be immediately taken to the operating room for rescue laparotomy or thoracotomy. Ultrasonography and chest radiography are performed before damage control surgery for hemodynamic unstable critical patients. Stable patients are scanned by CT and in some cases may benefit from non-operative strategy. Mortality remains high, initially due to bleeding complications and secondarily to infectious complications. Early and appropriate surgery can reduce morbidity and mortality. Non-operative strategy is only possible in selected patients in trained trauma centers and with intensive supervision by experienced staff.

Details

ISSN :
07507658
Volume :
32
Database :
OpenAIRE
Journal :
Annales Françaises d'Anesthésie et de Réanimation
Accession number :
edsair.doi...........822004c6a6334cc16df24159fd2082be
Full Text :
https://doi.org/10.1016/j.annfar.2012.12.006