The diagnosis and management of penetrating abdominal injury with large vessels damage in 18 cases / 中华普通外科杂志

ABSTRACT

Objective To investigate the experience of diagnosis and treatment of abdominal penetrating injury with large vessels damage.Methods The clinical data of 18 patients with abdominal large vessels injuries in our hospital from Jan 2003 to oct 2014 were analyzed retrospectively.Results 18 cases of large vessels injuries,accounting for 16.21％ during the same period of all penetrating wounds (18/111),emergency laparotomy was performed.There were 8 cases of arterial injury,4 cases of concurrent arteriovenous injury,6 cases of venous injury,Arterial and venous broken walls were repaired,splenic artery and venous ligation and splenectomy were performed.Vascular repair success rate was 100％,Intraoperative blood loss was 500-6 000 ml,average (3 750 ±670) ml.Operating time varied from 2.5 to 7 h,average (3.9 ±0.8) h.All patients were cured.12 cases were followed-up for 2-36 months,mean follow-up time was (15 ± 7) months,ultrasonography showed normal blood flow without complications.Conclusions Emergency surgical exploration and limited fluid resuscitation is the most effective therapy in abdominal penetrating injury involving large vessels.