Hemorrhagic shock is the leading cause of preventable death following injury. Historically, major advances in the management of hemorrhagic shock have come during periods of armed conflict, when hemorrhage occurs at higher rates and in situations where the military is…
Few injuries are as complex as pelvic fractures in the multiply injured patient. The pelvis is a complex anatomic region—the bony pelvis provides great protection to the structures it contains and within the pelvis are vital gastrointestinal, genitourinary, vascular, and…
The female reproductive organs are protected by their location in the pelvis, making injuries uncommon, except during pregnancy or situations in which they are pathologically enlarged. Gynecologic trauma includes a large variety of relatively rare and challenging injuries from blunt…
Kidney trauma Incidence and mechanisms of injury At most urban trauma centers, mechanisms of kidney injuries are predominantly blunt (80%–90%) and uncommonly penetrating (10%–20%). The kidney is injured in up to 5% of all trauma cases. Children are more likely…
Management of colon and rectal injuries has greatly evolved over recent decades. Historically, treatment consisted of resection and end colostomy based on experience with battlefield casualties. Although a difference between civilian and military injuries was recognized, the treatment by civilian…
After blunt or penetrating abdominal trauma, the major sites of hemorrhage are the viscera, mesentery, and major abdominal vessels ( Figs. 1–3 ). “Abdominal vascular injury” refers to injury to major intraperitoneal and retroperitoneal vessels and is classified into four…
The proclivity for the spleen to bleed from blunt abdominal trauma was not lost on the Thuggee cult. A group of professional assassins who existed from the 13th to 19th centuries in India, they murdered others to worship Kali, a…
The liver is the most commonly injured intraabdominal organ with an incidence of 30% to 40%. The overwhelming majority of liver injuries, however, are minor, with spontaneous cessation of hemorrhage almost always the rule, and operative intervention is rarely required.…
Injuries to the pancreas remain uncommon, occurring in <1% of all adult traumas and 3.7% to 11% of abdominal trauma. Despite advances in modern trauma care, including damage control surgery and improved imaging techniques, injuries to the pancreas present a…
Trauma surgeons must possess a comprehensive understanding of the diagnostic and treatment algorithms for duodenal injury as these injuries are unusual, but not rare, and can be difficult to diagnose. The surgical approaches are nuanced and can be complex, implying…