Abstract

ASENSIO, Juan A; PETRONE, Patrizio; KIMBRELL, Brian  and  KUNCIR, Eric. Abdominal vascular lesions: The trauma surgeon's challenge. rev. colomb. cir. [online]. 2007, vol.22, n.2, pp.124-134. ISSN 2011-7582.

Introduction: Abdominal vascular injuries in trauma patients exhibit very high mortality and morbidity rates. Methods: This is a clinical review of the diagnosis, surgical procedures, and treatment of patients with abdominal vascular injuries, based on the clinical experience with 302 patients presenting this type of injury. Results: Penetrating abdominal wounds account for 90% to 95% of all abdominal vascular injuries. Mutiple organ injuries are frequent. The clinical signs of hemoperitoneum and/or peritonitis and the absence of femoral pulses are indications for laparatomy. In patients with cardio-pulmonary arrest, an emergent thoracatomy with open cardiac massage and cross-clamping of the aorta should be performed. The global mortality rate is 54%. Exsanguination accounts for 85% of the deaths. Compartment syndrome of the abdomen and limbs, as well as the vicions circle of acidosis, hypothermia, and coagulopathy are the principle complications. Conclusions: Abdominal vascular injuries are associated wite a high mortality/morbidity rate. Precise knowledge of the retroperitoneal anatomy and of the surgical approaches to access these vessels, as well as the adequate clinical evalution will assist in lowering the mortality and complications rates in these patients.

Keywords : wounds and injuries; abdominal vascular injuries; abdominal aorta; inferior vena cava.

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