Major Abdominal Veins
Fig. 52.1 Functional zones of the retroperitoneum Once an intra-abdominal venous injury is identified, you should immediately be planning out your potential operative strategies: to ligate the injured vessel, to…
Major Abdominal Arteries
Artery Primary repair Graft or vein Ligate? Recommendations Aorta Prolene 3-0 or 4-0 Dacron 14–20 mm No Prefer left medial visceral rotation exposure Splenic N/A N/A Yes Splenectomy Common hepatic…
The Pediatric Patient
Adolescents Children Gunshot wounds homicidal Accidental gunshot injuries Gunshot wounds suicidal Gunshot wounds homicidal Stab injuries usually with knives or similar Penetrating stab injuries Arrows and other missiles Non-powder gun…
Loss of the Chest Wall
Fig. 41.1 Chest wall defect 5–10 cm in diameter with open pneumothorax, comminuted rib fractures, intercostal muscle tearing, and underlying pulmonary injury After airway management, examine the edges of the…
Injury of the Kidney, Ureter, and Bladder
Gradea Type of injury Description of injury ICD-9 AIS-90 I Contusion Microscopic or gross hematuria, urologic studies normal 866.01 2 Hematoma Subcapsular, nonexpanding without parenchymal laceration 866.11 2 II Hematoma…
Damage Control Surgery
Fig. 43.1 Resuscitation using blood products and fluid warmer 43.4.2 Haemostatic Resuscitation (Fig. 43.1) Early identification of patients with ongoing haemorrhage and the need for blood transfusion is essential so…
Axillary and Brachial Vessels
Fig. 65.1 The axillary artery begins as a continuation of the subclavian artery at the outer border of the first rib and ends at the lower border of the teres…
Penetrating Trauma: Amputations
Active hemorrhage Large, expanding, or pulsatile hematoma Bruit or thrill over wound Absent distal palpable pulses Manifestations of distal ischemia (pain, pallor, paralysis, paresthesias, poikilothermy) 63.1.2 Deciding Primary Amputation Versus…
Access to the Abdomen: Emergency Laparotomy
Fig. 42.1 Skin and subcutaneous tissue incision with the scalpel, while countertraction is applied on the two edges of the wound 2. Incise the linea alba with the scalpel….
