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 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 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 hemorrhagic shock? Shock exists when the cardiovascular system is no longer able to meet the body’s metabolic and oxygen needs, resulting in cellular injury. In other words, the tissues are not adequately perfused to meet their oxygen…