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Emergency Surgery
Emergency Surgery
Prof. Dr. med. Meftah A. Shwehdy
Head of surgery department
Faculty of medicine
7th October university
Misurata Libya
Emergency Surgery
2009/966
ISBN: 978-9959-55-072-9
7
First Edition
2010
Prof. Dr. med. Meftah A. Shwehdy
7
2620648 -2627203 - 2627202 - 2627201
051/2627350
2478
www.7ou.edu.ly
info@7ou.edu.ly
9090509 - 9096379 - 9097074
9097073
nat_lib_libya@hotmail.com
Contents
Foreward 7
Trauma and emergency surgery 9
Shock 33
Blood transfusion 39
Water and electrolytes 53
Head trauma 67
Thoracic trauma 79
Paediatric trauma 109
Abdominal trauma 129
Trauma in pregnancy 155
Acute abdominal pain 169
Peritonitis 181
Acute mesenteric ischemia 193
Acute perforation 201
Acute Appendicitis 207
Intestinal obstructions 219
Intra-abdominal abscesses 243
Acute surgical abdomen in pregnancy 251
Hernias and abdominal wall 257
Vascular injury 267
5
Foreword
Emergency surgery is growing so fast nowadays and the number
of patients visit to emergency departments is increasing rapidly. This
book is a short and practical manual, because it discusses the clinically
important features of various topics of surgical emergency.
Emergency surgery is not a substitute for textbooks of surgery, but
will hopefully offer a refresher course in clinical emergency surgery
and gives the students the chance to revise, what they already have
been read from comprehensive textbooks.
I hope that this book will be useful for undergraduates, as well as
general practitioners who like to recapitulate quickly various and
practical points in emergency surgery.
Meftah A. Shwehdy
7
Trauma And Emergency Surgery
I. Introduction.
Trauma is the leading cause of death and disability in the first four
decades of life and is the third most common cause of death overall.
In the 15-24 age group, injuries claim almost three times more lives
than the next leading cause of death. More than three out of four
victims in this age group are males.
Road traffic accidents remain the leading cause of traumas. In global
terms, pedestrians represent the largest group of fatalities on the road.
Falls are second only to vehicle collisions as a major cause of
traumatic deaths and injuries.
Other penetrating injuries caused by knives, guns and other devices.
Injury is labeled as the neglected disease of modern society. There is
a world wide increasing trend towards injuries caused by traumas.
The number of hospital admissions due to traumas is rapidly
increasing.
For every injury related death there are 10 other survivors with serious
injuries, two of whom will have permanent disabilities.
II. PATHOPHYSIOLOGY OF INJURY.
Some traumas could produce remarkably little tissue disruption or
haemodynamic instability. Other trauma patients may suffer injuries
that are rapidly fatal. This group of severely traumatized patients,
about 5%, has injuries that are not amendable to treatment and death is
9