[Preoperative leukocytosis as a predictor of intrabdominal injury in penetrating abdominal trauma]. / Leucocitosis prequirúrgica como factor predictivo de lesión a órgano intrabdominal en trauma penetrante abdominal.

BACKGROUND: in Mexico, the management of abdominal penetrating trauma doesn't follow the algorithms of Trauma Center level I, because of our limitations, and laparotomies are inevitable in this context. Is possible use some grade of leukocytosis suspect in-trabdominal lesion? METHODS: study retrospective, descriptive and analytic that inclu-ded patients with abdominal penetrating trauma that suffered exploratory laparotomy. We excluded patients' whit severe damage to soft tissues in extremities, thoracic affection, fractures, or da-mage in nervous system. We divided the patients into 2 groups: group I (therapeutic laparotomy) and group II (non-therapeutic laparotomy). Dependent variables were; age, gender, type of injury, number of lesions, peripheral lesions, time between injury and, from a laboaratory blood sample, leukocytosis mean, percentage of neutrophils, leukocytosis ≥ 12,500 /mm(3), and hemoperitoneum. We compared variables between two groups and use Pearson's χ(2) test and T-Student, and percentages as summary of measures. RESULTS: we included 231 patients, group I with 159 patients and group II with 72 patients. Leukocytosis global was 13.2 mil/mm(3) and neutrophil range of 70.3%. 26% of patients did not have leukocytosis at arrival and evaluation, however they were laparotomized because of present peritoneal irritation. Leukocytosis ≥ 12.5 mil/mm(3) was statistically significant in patients with intrabdominal lesions (74.2% vs 27.7%, p < 0.001). CONCLUSIONS: leukocytosis ≥ 12.5 mil/mm(3) could be an early serum marker abdominal penetrating trauma.

O hemoperitônio na gravidez tubária / The hemoperitonium in tubal pregnancy

Os autores estudam, retrospectivamente, o hemoperitônio em 21 pacientes com gravidez tubária no período de ago/87 a nov/91. As pacientes foram atendidas no Hospital Universitário da UFJF. Foram feitos estudos de incidência e comparativos entre o volume do hemoperitônio, a estabilidade hemodinâmica e a dosagem de hemoglobina no sangue periférico. Os autores concluíram que a origem e o volume do hemoperitônio näo teem valor preditivo quanto à evoluçäo hemodinâmica da paciente. E que, a dosagem da hemoglobina no sangue periférico informa sobre a instabilidade da paciente, mas näo se correlaciona com o volume do hemoperitônio.

Hemoperitoneum complicating chronic peritoneal dialysis: single-center experience and literature review.

Hemoperitoneum is a well-recognized, if uncommon, complication of chronic peritoneal dialysis. In this review of 424 patients maintained on peritoneal dialysis at a single center during an 11-year period, 26 patients (6.1%) developed one or more episodes of hemoperitoneum. Three patients had hemoperitoneum on two separate occasions with different etiologies. One additional patient was seen on a hospital consultative service. Three types of bleeding episodes were observed. Twenty-one of 30 (70%) were benign, consisting of pink-tinged dialysate with little clinical consequence (group 1). Three (10%) consisted of minor hemoperitoneum associated with significant intra-abdominal pathology (group 2), and six (20%) required active intervention (group 3). The most frequent cause of hemoperitoneum was bleeding related to menstruation or ovulation; hemoperitoneum was more common in women than in men. Two patients had hemoperitoneum occurring after more than 6 years on dialysis. In both, the etiology was sclerosing peritonitis, an association not previously noted. The less common etiologies of hemoperitoneum encountered in our patients were similar to those in reports from other centers and are compiled here.