2024-03-28T14:36:35Z
https://niigata-u.repo.nii.ac.jp/oai
oai:niigata-u.repo.nii.ac.jp:00019247
2022-12-15T03:50:12Z
453:456
471:537:538:1148
Surgical Management of Gastrointestinal Trauma (Emerency Medical Care : Current Advances and Problems in Treatment of the Severely Injured)
4) 腹部外傷患者の外科治療(シンポジウム 救急医療 : 重度外傷治療の進歩と今日の課題, 第492回新潟医学会)
4) 腹部外傷患者の外科治療(シンポジウム 救急医療 : 重度外傷治療の進歩と今日の課題, 第492回新潟医学会)
酒井, 靖夫
119892
畠山, 勝義
119893
gastrointestinal trauma
surgical treatment
腹部外傷
外科治療
Unstable and changeable property of the general conditions of gastrointestinal (GI) trauma patients often require quick and exact diagnosis and treatments. During past 3 years from 1990 through 1992, 69 patients (28, 23, and 18 in each year) admitted to the hospitals (Niigata Univ. Hosp., Niigata Citizen's Hosp. and Nagaoka Red-Cross Hosp.), because of abdominal trauma. Five cases of GI injury admitted to Niigata Univ. Hospital. Two of them with parenchymal organ injury, underwent operation because of hypovolemic shock due to intraabdominal bleeding from liver and spleen. Three patients with hollow organ injury were performed operation for panperitonitis, i.e., simple closure or partial intestinal resection and drainage. All patients were cured and discharged. Abdominal trauma is categorized into sharp and blunt trauma, or into parenchymal and hollow organ injury with regard to the types of trauma or organs. Major pathophysiology of the abdominal injury consists of intraabdominal bleeding from parnchymal organs and peritonitis (bacterial infection) caused by the rupture of hollow viscera. Two thirds of death is caused by the hemorrhagic shock, and sepsis associated with peritonitis is also popular reason of motality. From this point of view, treatment for bleeding and bacterial infection is the key to successful management. Operative indications are as follows; 1) massive intraabdominal bleeding, 2) peritonitis, 3) signs and symptoms that indicate hollow organ perforation. Essentials of operative procedures are 1) hemostasis, 2) repair or reconstruction of the damaged portions, 3) removal or excision of necrotic tissues and infectious foci, 4) induction of digestive juice, 5) adequate peritoneal irrigation and drainage, 6) if possible, preservation of organ functions. Operative procedure is dicided by following factors, such as degree and extent of damages, patient's general condition, local extent of contamination and duration from injury to operation.
departmental bulletin paper
新潟医学会
1994-07
application/pdf
新潟医学会雑誌
7
108
496
500
新潟医学会雑誌
AN00182415
00290440
https://niigata-u.repo.nii.ac.jp/record/19247/files/108(7)_496-500.pdf
jpn