Alberto García, Mauricio Millán, Daniela Burbano, Carlos A Ordoñez, Michael W Parra, Adolfo González Hadad, Mario Alain Herrera, Luis Fernando Pino, Fernando Rodríguez-Holguín, Alexander Salcedo, María Josefa Franco, Ricardo Ferrada, Juan Carlos Puyana
{"title":"Damage control in abdominal vascular trauma.","authors":"Alberto García, Mauricio Millán, Daniela Burbano, Carlos A Ordoñez, Michael W Parra, Adolfo González Hadad, Mario Alain Herrera, Luis Fernando Pino, Fernando Rodríguez-Holguín, Alexander Salcedo, María Josefa Franco, Ricardo Ferrada, Juan Carlos Puyana","doi":"10.25100/cm.v52i2.4808","DOIUrl":null,"url":null,"abstract":"<p><p>In patients with abdominal trauma who require laparotomy, up to a quarter or a third will have a vascular injury. The venous structures mainly injured are the vena cava (29%) and the iliac veins (20%), and arterial vessels are the iliac arteries (16%) and the aorta (14%). The initial approach is performed following the ATLS principles. This manuscript aims to present the surgical approach to abdominal vascular trauma following damage control principles. The priority in a trauma laparotomy is bleeding control. Hemorrhages of intraperitoneal origin are controlled by applying pressure, clamping, packing, and retroperitoneal with selective pressure. After the temporary bleeding control is achieved, the compromised vascular structure must be identified, according to the location of the hematomas. The management of all lesions should be oriented towards the expeditious conclusion of the laparotomy, focusing efforts on the bleeding control and contamination, with a postponement of the definitive management. Their management of vascular injuries includes ligation, transient bypass, and packing of selected low-pressure vessels and bleeding surfaces. Subsequently, the unconventional closure of the abdominal cavity should be performed, preferably with negative pressure systems, to reoperate once the hemodynamic alterations and coagulopathy have been corrected to carry out the definitive management.</p>","PeriodicalId":50667,"journal":{"name":"Colombia Medica","volume":null,"pages":null},"PeriodicalIF":0.7000,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ba/d2/1657-9534-cm-52-02-e10.PMC8754163.pdf","citationCount":"3","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Colombia Medica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.25100/cm.v52i2.4808","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/4/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 3
Abstract
In patients with abdominal trauma who require laparotomy, up to a quarter or a third will have a vascular injury. The venous structures mainly injured are the vena cava (29%) and the iliac veins (20%), and arterial vessels are the iliac arteries (16%) and the aorta (14%). The initial approach is performed following the ATLS principles. This manuscript aims to present the surgical approach to abdominal vascular trauma following damage control principles. The priority in a trauma laparotomy is bleeding control. Hemorrhages of intraperitoneal origin are controlled by applying pressure, clamping, packing, and retroperitoneal with selective pressure. After the temporary bleeding control is achieved, the compromised vascular structure must be identified, according to the location of the hematomas. The management of all lesions should be oriented towards the expeditious conclusion of the laparotomy, focusing efforts on the bleeding control and contamination, with a postponement of the definitive management. Their management of vascular injuries includes ligation, transient bypass, and packing of selected low-pressure vessels and bleeding surfaces. Subsequently, the unconventional closure of the abdominal cavity should be performed, preferably with negative pressure systems, to reoperate once the hemodynamic alterations and coagulopathy have been corrected to carry out the definitive management.
期刊介绍:
Colombia Médica is an international peer-reviewed medical journal that will consider any original contribution that advances or illuminates medical science or practice, or that educates to the journal''s’ readers.The journal is owned by a non-profit organization, Universidad del Valle, and serves the scientific community strictly following the International Committee of Medical Journal Editors (ICMJE) and the World Association of Medical Editors (WAME) recommendations of policies on publication ethics policies for medical journals.
Colombia Médica publishes original research articles, viewpoints and reviews in all areas of medical science and clinical practice. However, Colombia Médica gives the highest priority to papers on general and internal medicine, public health and primary health care.