Stručni rad

Haemorrhage from the parenchymatous organs of the abdomen

Ivo Mlinarić
Andrija Georgijević
Milan Ilić
Mario Ledinsky
Stjepan Geceg
Edvard Missoni
Đuro Vlašić

Sažetak

In everyday surgical practice, bleedings from parenchymatous organs of the abdomen are mostly reduced to bleedings from the liver and spleen. Bleeding after the injury of pancreas is usually not very strong, whereas the bleeding connected with haemorrhagic pancreatitis can be very strong. Bleeding from the uterus and ovaries belongs to the sphere of gynecological practice and the bleeding from kidneys to the sphere of urology. A surgeon can meet them in polytraumatic patients. Bleedings from the liver and spleen are mostly strong and can endanger the patient’s life. Because of that, preoperative diagnostics should be very fast and efficient, to enable a suitable surgical therapy to be applied on time. The causes of bleeding from parenchymatous organs are mostly the injuries in an accident or jatrogenic management. Bleeding caused by pathologic processes is rather rare. In the open injuries of the abdomen liver is damaged more often than spleen, whereas in closed injuries the opposite is true. Rapid increase in traffic accidents causes the corresponding increase in injuries of the parenchymatous organs of the abdomen, which are mostly a part of polytrauma. The prognosis of these injuries depends on the extent of the main injury, the amount of bleeding and the factor of time. In the diagnostic procedure open injuries do not cause many problems, because here, with few exceptions, explorative laparatomy is indicated. The greatest problem are the injuries of the abdomen and the lower part of the thorax connected with hypovolemic shock. These states demand an urgent treatment in the nearest medical institution, regardless of its equipment. Because of that, in the diagnostic procedure the value of punction and lavage of the abdomen is emphasized, for it can be done in any medical institution. The opinion must be corrected that in case of liver injury ist tissue should be kept, while the spleen can be removed without dangerous consequences. The liver tissue should be kept, but only if its vitality is preserved, because the later surgical treatment is more difficult and dangerous. Splenectomy has a number of serious consequences, especially in children. It chiefly refers to the lack of immunity of the human body and resistlessness to infections, leading to high mortality rate. Therefore, if the spleen cannot be preserved by surgical operations, it must be reimplanted. This is justified only if there is no bacterial contamination with the signs of peritonitis. In favour of such a statement speak both the statistics and the experience from our Departments of General Surgery.

Ključne riječi

haemorrhage; abdominal injuries

Hrčak ID:

196774

URI

https://hrcak.srce.hr/196774

Datum izdavanja:

1.12.1989.

Podaci na drugim jezicima: hrvatski

Posjeta: 4.735 *