Incizii toraco-abdominale: se utilizează pentru expunerea ficatului și a incizie mediană xifo-ombilicală: în cazul unor traumatisme abdominale;; incizii pentru. traumatisme abdominal fermé translation english, French - English dictionary, meaning, see also 'traumatisme crânien',traumatiser',traumatisme crânien'. Traumatismes abdominaux: diagnostic et traitement radiologique Embed Share. Traumatisme abdominale fermÃ© TAF gÃ©nÃ©ralitÃ©.
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Incizie chirurgicală - Wikipedia
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Diagnosis Clinical evaluation Often CT or ultrasonography As in all patients experiencing significant trauma, clinicians do a thorough, traumatisme abdominale trauma evaluation simultaneous with resuscitation see Approach to the Trauma Patient.
Because many intra-abdominal injuries heal without specific treatment, the clinician's primary goal is to identify injuries requiring intervention. Following clinical evaluation, a few patients clearly require exploratory laparotomy rather than testing, including those with Traumatisme abdominale Hemodynamic instability due to penetrating abdominal trauma Gunshot wounds most Evisceration Conversely, a few patients are at very low risk and may be discharged or observed briefly without any testing other than visual inspection of the urine traumatisme abdominale gross blood.
These patients typically have isolated blunt abdominal trauma and a minor mechanism of injury, normal sensorium, and no tenderness or peritoneal signs; they should be instructed to return immediately if pain worsens.
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Patients with isolated anterior abdominal stab wounds that have not penetrated the fascia can also be observed briefly traumatisme abdominale discharged 1. However, most patients do not have such clear-cut positive or negative manifestations and thus require testing to evaluate for intra-abdominal injury.
Testing options include Imaging studies ultrasonography, CT Procedures traumatisme abdominale exploration, diagnostic peritoneal lavage In addition, patients usually should have a chest x-ray to look for free air traumatisme abdominale the diaphragm indicating perforation of a hollow viscus and an elevated hemidiaphragm suggesting diaphragmatic rupture.
Pelvis x-ray is done in patients with pelvic tenderness or significant deceleration and an unreliable clinical examination. Laboratory testing is secondary. Urinalysis to detect hematuria gross or microscopic is helpful, and for patients with apparently serious injuries, CBC is valuable to establish baseline Hct.
Pancreatic and liver enzyme levels are not sufficiently sensitive or specific for significant organ injury to be recommended. The blood bank should do a type and screen in case blood transfusions are possible; type and cross-match is done if transfusion is very likely.
Serum lactate level or base deficit calculation from arterial blood gas testing may help identify occult shock. The method chosen to detect intra-abdominal injury varies by mechanism of injury and the clinical examination.
Penetrating abdominal trauma Blindly probing wounds with a blunt instrument eg, cotton swab, fingertip should not be done. If the peritoneum has been violated, probing may introduce infection or cause further damage. Stab wounds including impalements to the anterior abdomen between the 2 anterior axillary lines in hemodynamically stable patients without peritoneal signs can be explored locally.
traumatisme abdominale Typically, local anesthesia is given and the wound is opened enough to allow complete visualization of the entire tract. If the anterior fascia is penetrated, patients are admitted for serial clinical examinations; exploratory laparotomy is done if peritoneal signs or hemodynamic instability develop.
If the fascia is not violated, the wound is cleansed and repaired and traumatisme abdominale patient discharged.
Alternatively, some centers do CT, or less commonly, diagnostic peritoneal lavage DPLto evaluate patients with fascial penetration. For gunshot wounds, most clinicians do exploratory laparotomy unless the wound is clearly grazing traumatisme abdominale tangential and traumatisme abdominale and hypotension are absent.
However, some centers that use nonoperative management of select patients with only solid organ typically liver injury do CT of stable patients with gunshot wounds.
Local wound exploration is typically not done for gunshot wounds. Typically, clinicians use ultrasonography or Traumatisme abdominale, or sometimes both. This training course is based on an ancient methodology that centers on the learning of a traumatisme abdominale gesture: