Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_2104_Библиотеки_им_академика_М_И_Перельмана.pdf
EMERGENCY AND INTENSIVE CARE MEDICINE
ABDOMINAL TRAUMA
AND ABDOMINAL
A
ORTIC ANEURYSMS
SYMPTOMS, DIAGNOSTIC METHODS
AND
TREATMENT OUTCOMES
No part of this digital document may be reproduced, stored in a retrieval system or transmitted in any form or
by any means. The publisher has taken reasonable care in the preparation of this digital document, but makes no
expressed or implied warranty of any kind and assumes no responsibility for any errors or omissions. No
liability is assumed for incidental or consequential damages in connection with or arising out of information
contained herein. This digital document is sold with the clear understanding that the publisher is not engaged in
rendering legal, medical or any other professional services.
EMERGENCY AND INTENSIVE
C
ARE MEDICINE
Additional books in this series can be found on Nova’s website
under the Series tab.
Additional e-books in this series can be found on Nova’s website
under the e-book tab.
EMERGENCY AND INTENSIVE CARE MEDICINE
ABDOMINAL TRAUMA
AND ABDOMINAL
A
ORTIC ANEURYSMS
SYMPTOMS, DIAGNOSTIC METHODS
AND
TREATMENT OUTCOMES
LOUISE SANTIAGO
EDITOR
New York
Copyright © 2015 by Nova Science Publishers, Inc.
All rights reserved. No part of this book may be reproduced, stored in a retrieval system or transmitted
in any form or by any means: electronic, electrostatic, magnetic, tape, mechanical photocopying,
recording or otherwise without the written permission of the Publisher.
We have partnered with Copyright Clearance Center to make it easy for you to obtain permissions to
reuse content from this publication. Simply navigate to this publication’s page on Nova’s website and
locate the “Get Permission” button below the title description. This button is linked directly to the
title’s permission page on copyright.com. Alternatively, you can visit copyright.com and search by
title, ISBN, or ISSN.
For further questions about using the service on copyright.com, please contact:
Copyright Clearance Center
Phone: +1-(978) 750-8400 Fax: +1-(978) 750-4470 E-mail: info@copyright.com.
NOTICE TO THE READER
The Publisher has taken reasonable care in the preparation of this book, but makes no expressed or
implied warranty of any kind and assumes no responsibility for any errors or omissions. No liability is
assumed for incidental or consequential damages in connection with or arising out of information
contained in this book. The Publisher shall not be liable for any special, consequential, or exemplary
damages resulting, in whole or in part, from the readers’ use of, or reliance upon, this material. Any
parts of this book based on government reports are so indicated and copyright is claimed for those parts
to the extent applicable to compilations of such works.
Independent verification should be sought for any data, advice or recommendations contained in this
book. In addition, no responsibility is assumed by the publisher for any injury and/or damage to
persons or property arising from any methods, products, instructions, ideas or otherwise contained in
this publication.
This publication is designed to provide accurate and authoritative information with regard to the subject
matter covered herein. It is sold with the clear understanding that the Publisher is not engaged in
rendering legal or any other professional services. If legal or any other expert assistance is required, the
services of a competent person should be sought. FROM A DECLARATION OF PARTICIPANTS
JOINTLY ADOPTED BY A COMMITTEE OF THE AMERICAN BAR ASSOCIATION AND A
COMMITTEE OF PUBLISHERS.
Additional color graphics may be available in the e-book version of this book.
Library of Congress Cataloging-in-Publication Data
Librar
y of Congress Control Number: 2015946410
Published by Nova Science Publishers, Inc. † New York
ISBN: (eBook)
CONTENTS
Preface vii
Chapter 1 Blunt Abdominal Trauma in Children 1
Natalie L. Yanchar
Chapter 2 Open Abdomen Management for Abdominal Trauma:
Indications and Surgical Modalities 31
Stefano Rausei, Vincenzo Pappalardo,
Francesco Amico, Francesco Frattini, Luigi Boni,
Francesca Rovera and Gianlorenzo Dionigi
Chapter 3 Bacterial Peritonitis and Intra-Abdominal
Abscesses Post Abdominal Trauma:
Etiology and Antimicrobial Therapy in the
Era of Multi-drug Resistance 67
Wen-Liang Yu and Khee-Siang Chan
Chapter 4 Serious Abdominal Consequences of Falls
and Non-Penetrating ‘Minor’ Abdominal
Trauma among Older Adults 87
Ami Schattner and Meital Adi
Chapter 5 Abdominal Aortic Aneurysms and Periodontitis 103
Jun-ichi Suzuki and Norio Aoyama
Index 111
PREFACE
In this book, the epidemiology, identification of and management of
injuries sustained from blunt abdominal trauma (BAT) in childhood are
discussed, with a focus on recent advances and future research. Open abdomen
(OA), which refers to leaving abdominal incisions open after surgical
procedures, and its management are presented as well. Also in this book,
bacterial peritonitis and intra-abdominal abscesses, which are major
complicated intra-abdominal infections post abdominal trauma are discussed.
The severe abdominal consequences of falling, particularly among older
adults, is reviewed as well. Finally, periodontitis is known to be a risk factor
for abdominal aortic aneurysm (AAA). The authors focus on the role of
specific periodontopathic bacteria in AAA and are able to conclude that
periodontal pathogens play a major, critical role in AAA development.
Chapter 1 – Fifty years ago, the acceptance of non-operative management
of isolated solid organ injuries was a radical advancement in the care of
children and youth with blunt abdominal trauma (BAT). Since then,
refinements of care of these injury patterns have revolved around protocols for
length of bedrest and timing of return to activities, imaging modalities and
grading of severity, resuscitation and identification of need for operative
intervention or less-invasive arterial embolization, damage-control surgery and
techniques to spare loss of the spleen. The concept of regional trauma systems
as a means to ensure patients receive definitive treatment at appropriate levels
of care has led to further improvements in outcomes with less use of computed
tomography (CT) and associated exposure to ionizing radiation and
significantly less operative interventions. Ongoing research to identify
clinically significant injuries with more judicious use of CT, developing triage
guidelines within regional trauma systems, more clearly defining the role of
Louise Santiago viii
focused abdominal sonography for trauma (FAST) and abbreviating the need
of hospital admission for less severe injuries can allow for more efficient use
of resources, reduce the impact of prolonged hospitalization on families and
the system and optimize outcomes of children and youth with BAT. This
chapter will discuss the epidemiology, identification of and management of
injuries sustained from BAT in childhood, with a focus on these recent
advances and future research.
Chapter 2 – Open abdomen (OA) is a term currently used to refer to
leaving abdominal incision open after surgical procedure. Indications for OA
management are heterogeneous and consensus has not been reached to date.
However, in trauma setting damage control surgery and abdominal
compartment syndrome are the most common indications for such treatment.
OA is usually managed with temporary abdominal closure (TAC) techniques.
TAC is an attempt to control fluid losses, minimize the loss of domain, and to
reduce fascial retraction. These techniques are also used as a bridge treatment
to facilitate patient management until definitive closure is obtained. OA
management is a result of a conjunct effort of surgeons and anesthesiologists.
Such collaboration could also increase any possibility to produce high quality
evidence in this field: in fact, an agreement about the right timing and method
for abdominal closure is still to be obtained. A literature review will be
presented to try to clarify crucial aspects of this topic.
Chapter 3 – Bacterial peritonitis and intra-abdominal abscesses are major
complicated intra-abdominal infections post abdominal trauma. These
infections are often associated with intestinal or mesenteric ischemic injury,
hollow organ gangrene or perforation, intra-abdominal visceral laceration,
infarction or perforation, severe pancreatitis, penetrating injury and
anastomotic fistula. Infections occur following the invasion of pathogenic
bacteria into the abdominal cavity or the involved organs. These infections
mainly manifest as diffuse peritonitis, peritoneal abscesses, or multiple intra-
abdominal visceral abscesses that require treatment combining surgical
protocols with anti-infective agents. Sepsis can occur due to the invasion of
numerous bacteria and toxins into the blood circulation, which may further
progress to septic shock, respiratory distress syndrome, acute renal failure as
well as intestinal and hepatic dysfunction.
Currently, the predominant causative bacteria include Gram-negative
bacteria, such as Escherichia coli (E. coli), Klebsiella pneumoniae (K.
pneumoniae) and Pseudomonas aeruginosa (P. aeruginosa) as well as Gram-
positive bacteria like Staphylococcus aureus (S. aureus) and Enterococcus