1 What is the most common type of renal trauma in the United States, blunt or penetrating? Approximately 90% of renal injuries are caused by blunt mechanism in the United States. 2 Why are pediatric patients more susceptible to major…
1 What are the first steps in the evaluation and treatment of a patient with pelvic ring injuries? Severely injured patients with high-energy acute pelvic ring disruptions are at high risk of mortality from associated exsanguinating hemorrhage. Diagnostic workup strategies…
Colon Trauma 1 How do most colon injuries occur? Nearly all (>95%) colon injuries are caused by penetrating trauma from a gunshot, a stab wound, an iatrogenic injury, or a sexual injury. Blunt colonic trauma is rare and usually results…
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…