1 How common are pancreatic and duodenal injuries? Injury to the pancreas and duodenum remain uncommon, likely because of the intimate association with other vital structures within the retroperitoneum. The recently documented incidence of duodenal injury is 0.2%–0.3%, followed by…
1 What is the physiologic role of the spleen? In fetal development, the spleen serves as a major site of hematopoiesis. Later in life the spleen produces immunoglobulin M (IgM), properdin, and tuftsin, important factors in immunologic function. The spleen…
1 How often is the liver injured in trauma? The liver is both large and central, so it is vulnerable to blunt trauma and an easy target for penetrating wounds. It is the most frequently injured intraabdominal organ in trauma.…
1 Why is the evaluation different for patients with stab wounds (SWs) versus gunshot wounds (GSWs)? Although one-third of SWs to the anterior abdomen do not penetrate the peritoneum, 80% of GSWs violate the peritoneum. Additionally, of those wounds that…
1 What are the key components of the history and physical exam when evaluating a patient with blunt abdominal trauma? The tenets of the initial assessment and resuscitation of patients with blunt abdominal trauma remain the same as with all…
1 How often do patients with penetrating chest wounds need an operation? Most penetrating injuries seen in civilian practice are from knives and low-energy handguns. Consequently, although injuries to the chest wall and lung are common, the vast majority can…
1 How often do patients with isolated blunt chest trauma need an emergent operation? Rarely. The majority of injuries can be managed with aggressive pain control, mechanical ventilation, tube thoracotomy, and other simple supportive care. Only 5% of patients with…
1 Why are penetrating neck wounds unique? Although comprising only a small percentage of body surface area, the neck contains a heavy concentration of vital structures: Vascular (common, internal, and external carotid arteries, vertebral arteries, internal and external jugular veins)…
1 What is the difference between a spinal column injury and a spinal cord injury? Injuries to the spinal column can include damage to bone, disks, and/or ligaments. These injuries may induce spinal instability. Instability results when the spine can…
1 Is traumatic brain injury (TBI) a common problem? Yes. In the United States, 1 in 12 deaths are due to injury. About 30% of traumatic deaths are associated with TBI. Of deaths resulting from motor vehicle accidents, 60% are…