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Article type: Research Article
Authors: Naess, F. | Nesbakken, A. | Solheim, K.; | Pillgram-Larsen, J. | Gerner, T. | Stadaas, J.O.
Affiliations: Department of Surgery, Ullevål University Hospital, Oslo, Norway
Note: [] Correspondence to: Kaare Solheim M.D., Professor of Surgery, Ullevål University Hospital, N-0407 Oslo 4, Norway.
Abstract: Abdominal organ injuries caused by blunt trauma are notoriously difficult to diagnose and a vital operation may as a result be dangerously delayed. In a series of 331 patients admitted after blunt abdominal trauma, 426 abdominal organ injuries were registered. 152 of these patients had 199 abdominal organ injuries requiring surgical repair. In 31 of these patients (20%) with 44 organ injuries operation was delayed for more than 6 hours after admission, in most instances because the diagnosis had been missed. One of these patients died as a consequence. Hollow organ injuries were the most commonly missed. Peritoneal lavage, repeated if necessary, and diagnostic imaging must be used as valuable tools in addition to repeated clinical evaluation, especially in comatose patients, in patients with multiple injuries, and in intoxicated patients.
Keywords: Blunt trauma, Missed diagnosis, Delayed treatment, Laparotomy
DOI: 10.3233/JRS-1990-1207
Journal: International Journal of Risk and Safety in Medicine, vol. 1, no. 2, pp. 141-147, 1990
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