Laparoscopic diagnosis and treatment of blunt abdominal trauma

This is an automatically translated article.

The article is professionally consulted by Master, Doctor Mai Vien Phuong - Gastroenterologist - Department of Medical Examination & Internal Medicine - Vinmec Central Park International General Hospital.
In the treatment of trauma in general as well as abdominal trauma in particular, it is very complicated because the nature and extent of damage in each patient is not the same, especially those who have both damage to internal organs and injuries. in the brain, chest... the diagnosis is more difficult.
Early diagnosis and treatment can prevent further progression and avoid emergency situations, so see your doctor as soon as possible to avoid this.

1. What is blunt abdominal trauma? What are the characteristics?

Abdominal trauma can be a closed or open injury that damages the abdomen. Abdominal trauma carries the risk of severe blood loss and infection. The diagnosis can be based on blood tests, ultrasound, X-ray, computed tomography, abdominal lavage..., the patient may need surgery for diagnosis and treatment. Trauma to the lower chest area can cause rupture of the spleen or liver.
Abdominal trauma has the following common features:
Injury to solid organs causing acute blood loss Hollow visceral injury causing peritonitis Combined injury: In the patient there is damage to both solid and hollow visceral organs, or Abdominal injuries accompanied by other organs: Brain, lungs, bones, muscles,... Currently, laparoscopy is a method being applied and brings highly accurate results. On the monitor, the doctor can see broken lines of the liver, spleen, and kidneys and see fluid in the abdomen (blood).

2. Signs of abdominal trauma

Common signs and symptoms include:
Abdominal pain, tenderness Abdominal stiffness to the touch and bruising on the outside of the abdomen Nausea Blood in urine Loss of bowel sounds Signs and symptoms of the disease often go undetected in the first few days but after many days when the first pain appears.
Persons injured in a motor vehicle crash may develop a “Seat Belt Mark”, a bruise on the abdomen along the seat belt loop area and this sign may indicate that the muscles The abdominal organs were injured.
Tension of the abdominal wall muscles is a response to protect the inflamed organs in the abdomen. Pneumoperitoneum appears air or gas in the abdominal cavity, this is a sign of rupture of the hollow viscera.
Injuries related to intra-abdominal trauma include:
Rib fractures Spinal fractures Pelvic fractures Injury to the abdominal wall.

3. Role of laparoscopy in diagnosis and treatment of blunt abdominal trauma

The majority of deaths in blunt abdominal trauma are due to delayed diagnosis leading to late surgery or misdiagnosis leading to errors in treatment techniques. There have been many surgeries that are exploratory or minimally invasive.
Diagnostic techniques include computed tomography, ultrasound and X-ray.
X-rays can help detect the route of entry and identify any foreign matter remaining in the wound, but this method is not feasible for open abdominal trauma. Abdominal lavage can be used to look for damage to the abdominal organs. However, this method carries the risk of damaging the abdominal organs, is difficult to perform, and leads to unnecessary surgery, so this method has largely been replaced by ultrasound in Europe and North America. . Ultrasound can detect fluid such as blood or digestive matter in the abdominal cavity and is a non-invasive and relatively safe procedure for the patient. Computed tomography is the preferred technique for people who are not at risk for shock. People with abdominal trauma often need computed tomography to look for other injuries, eg computed tomography of the head or thorax, in these cases an abdominal computed tomography may be done with time so as not to waste time in patient care. In today's modern medicine, doctors can use laparoscopic endoscopy (NSOB) as a diagnostic measure with high accuracy because it can directly see the lesion and is also a way to treat the lesion. effective but least invasive.
Diagnostic laparoscopy is a form of laparoscopic surgery to look at the organs inside the abdomen and pelvis. During the diagnostic endoscopy, if the doctors find an abnormal problem that can be treated immediately, some minor surgery will be performed.
Compared with open surgery, laparoscopic surgery has more advantages thanks to small scars, less pain, short hospital stay, fast recovery, and early return to normal life.
Performing laparoscopic surgery and other types of surgery should generally be carried out in reputable hospitals to minimize the possibility of possible complications. Vinmec International General Hospital gathers a team of qualified and skilled medical doctors from all over the country and abroad; The equipment system is invested heavily, meeting international standards, thus ensuring the best possible surgery.

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