دورية أكاديمية
Diagnostic and therapeutic challenges of isolated small bowel perforations after blunt abdominal injury in low income settings: analysis of twenty three new cases.
| العنوان: | Diagnostic and therapeutic challenges of isolated small bowel perforations after blunt abdominal injury in low income settings: analysis of twenty three new cases. |
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| المؤلفون: | Chichom Mefire A; Faculty of Health Sciences, University of Buea and Regional Hospital, Limbe, Cameroon. Electronic address: alainchichom@yahoo.com., Weledji PE, Verla VS, Lidwine NM |
| المصدر: | Injury [Injury] 2014 Jan; Vol. 45 (1), pp. 141-5. Date of Electronic Publication: 2013 Apr 03. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: Netherlands NLM ID: 0226040 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-0267 (Electronic) Linking ISSN: 00201383 NLM ISO Abbreviation: Injury Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <2002->: Amsterdam : Elsevier Original Publication: Bristol, Wright. |
| مواضيع طبية MeSH: | Physical Examination* , Poverty Areas*, Abdominal Injuries/*diagnosis , Intestinal Perforation/*diagnosis , Peritonitis/*diagnosis , Physicians/*standards , Wounds, Nonpenetrating/*diagnosis, Abdominal Injuries/diagnostic imaging ; Abdominal Injuries/mortality ; Adolescent ; Adult ; Cameroon/epidemiology ; Child ; Clinical Competence ; Delayed Diagnosis ; Female ; Health Resources/statistics & numerical data ; Humans ; Intestinal Perforation/diagnostic imaging ; Intestinal Perforation/etiology ; Intestinal Perforation/mortality ; Male ; Peritonitis/diagnostic imaging ; Peritonitis/mortality ; Peritonitis/prevention & control ; Practice Guidelines as Topic ; Prospective Studies ; Radiography ; Risk Factors ; Time Factors ; Wounds, Nonpenetrating/complications ; Wounds, Nonpenetrating/diagnostic imaging ; Wounds, Nonpenetrating/mortality |
| مستخلص: | Background: Isolated small bowel injury (ISBI) related to abdominal blunt trauma is rare. Timely diagnosis could be difficult, especially in the absence of modern imaging and laparoscopic facilities. The determinants of mortality under such circumstances are unclear. Methods: This study presents twenty three cases of ISBI related to blunt abdominal injury identified between January 2005 and December 2009 in a level III Hospital in Limbe, Cameroon. Data were retrieved from an ongoing prospective study on injuries and augmented by analysis of individual patient's files. We analysed information regarding modalities of diagnosis, delay between injury and diagnosis, operative findings, treatment and outcome. Results: The ages of our patients ranged from 7 to 38 years with a mean of 19 years. Thirteen patients were children below the age of 16. The most frequent mechanism of injury was a fall (n=11). Associated lesions were identified in 7 patients. Delay between injury and diagnosis was above 12h in 16 patients. Fifteen cases were admitted with obvious signs of peritonitis. Erect chest X-ray identified a pneumoperitoneum in 11 of the 17 patients for whom it was requested. Most perforations were located in the ileum. A total of 7 complications occurred in 5 patients. These included 4 cases of post-operative peritonitis. Two patients with at least one associated lesion died. Conclusion: ISBI is seldom suspected. This causes delay in diagnosis and most cases present with a diffuse peritonitis. Early diagnosis and management in low income environment is likely to be improved by a greater awareness of clinicians about this injury, serial clinical assessment and repeated erect chest X-ray, rather than sophisticated tools such as CT scan or laparoscopy. (Copyright © 2013 Elsevier Ltd. All rights reserved.) |
| التعليقات: | Comment in: Injury. 2014 Jun;45(6):1021-2. (PMID: 24656302) |
| فهرسة مساهمة: | Keywords: Abdominal blunt trauma; Delay; Diagnosis; Isolated small bowel injury; Low income setting; Management |
| تواريخ الأحداث: | Date Created: 20130409 Date Completed: 20150810 Latest Revision: 20220311 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1016/j.injury.2013.02.022 |
| PMID: | 23561583 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1879-0267 |
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| DOI: | 10.1016/j.injury.2013.02.022 |