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Poškodbe črevesa in mezenterija z varnostnim pasom = Injury to the intestines and mesentery caused by seatbelts
Pleskovič, Alojz ; Vidmar, Dubravka ; Tonin, Martin
Facts: In car accidents, injury to the intestines and mesentery caused by seatbelts is not an uncommon phenomenon, and timely diagnosis thereof is very difficult. A delay in establishing the ...diagnosis means significantly higher morbidity and mortality among the surgically treated injured people. Besides clinical examination and laboratory tests, ultrasound (US), native abdominal x-rays, computer tomography (CT) and laparoscopy are available. In the paper, the diagnostic procedures applied in 19 cases of people with damaged intestines and mesentery in Slovenia in 1999 are analysed. Patients and methods: Of the 19 injured people, who had an average age of 34 years (rangingfrom 12 to 75), suffering from abdominal injuries caused by seatbelts in road accidents, seven had isolated intestinal injuries and 12 had other injures in addition to intestinal ones. Peritoneal drainage was performed on four of the injured people, ultrasonic examination of the abdomen on 12, computer tomography on two, and laparoscopy on three. Results: In seven of the19 cases surgery was performed within 12 hours, in nine it was performed within 24 hours, and in three it was performed more than 24 hours after the injury. Hospitalisation periods ranged from one week to half a year. Seven of the injured people died. Conclusions: In the injured people who suffered typical injury mechanisms and contusion marks, an ultrasonic examination and anative abdominal x-ray need to be performed in addition to a thorough clinical examination and laboratory tests. In the event of negative results, US should be repeated at shorter intervals and CT examination performed. In unclear cases laparascopy can be employed. Only in this way can the time from the occurrence of injury to surgery be shortened and the morbidity and mortality among the injured people reduced.
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