Management and outcome of abdominal shotgun wounds. Trauma score and the role of exploratory laparotomy.

Abstract:

OBJECTIVE:The management and outcome of 138 abdominal shotgun wounds were examined over a 5-year period. SUMMARY BACKGROUND DATA:It has been proposed that exploratory laparotomy may be unnecessary and even overused in a subset of patients with abdominal shotgun wounds. METHODS:Data on shotgun wound patients from October 1987 through March 1992 from a statewide trauma registry were examined. Patients with abdominal shotgun wounds were identified and compared with patients with nonabdominal shotgun wounds. RESULTS:Of 516 shotgun wound patients, 138 (26.7%) had abdominal wounds and 88 (63.8%) had exploratory laparotomies. Abdominal shotgun wounds resulted in significantly longer number of intensive care unit days (4.3 vs. 2.5, p < 0.05), a greater number of blood units transfused (7.8 vs. 2.4, p < 0.05), and a higher mortality (15.9% vs. 4.8%, p < 0.05) when compared with nonabdominal shotgun wounds. When stratified for trauma score, the mortality for abdominal shotgun wounds always was significantly greater than for nonabdominal shotgun wounds. All abdominal shotgun wound patients with trauma scores less than ten died. The negative laparotomy rate for abdominal shotgun wound patients with normal trauma scores was 9.4%. No patient with a negative laparotomy died. CONCLUSION:Abdominal shotgun wounds are a particularly lethal subset of shotgun wounds. Although some abdominal shotgun wound patients can be managed without laparotomy, the morbidity and mortality for these injuries are substantial, even in patients with normal trauma score. Clinical judgment is an excellent predictor of the need for laparotomy.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Cairns BA,Oller DW,Meyer AA,Napolitano LM,Rutledge R,Baker CC

doi

10.1097/00000658-199503000-00009

subject

Has Abstract

pub_date

1995-03-01 00:00:00

pages

272-7

issue

3

eissn

0003-4932

issn

1528-1140

journal_volume

221

pub_type

临床试验,杂志文章
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    abstract:OBJECTIVE:To assess long-term outcome and prognostic factors for extreme surgery by vascular and plastic surgical teamwork for leg salvage in patients with critically ischemic large tissue defects. SUMMARY BACKGROUND DATA:Combined vascular reconstruction and microvascular free-flap transfer has been used to improve di...

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    doi:10.1097/01.sla.0000247985.45541.e8

    authors: Tukiainen E,Kallio M,Lepäntalo M

    更新日期:2006-12-01 00:00:00

  • Risk and location of cancer in patients with preoperative colitis-associated dysplasia undergoing proctocolectomy.

    abstract:OBJECTIVE:To evaluate the influence of preoperative dysplasia grade, appearance, and site on risk and location of cancer in patients with colitis. BACKGROUND:The ability to predict the presence and location of cancer in colitis patients with dysplasia is essential to facilitate recommendations regarding the necessity ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31828e7417

    authors: Kiran RP,Ahmed Ali U,Nisar PJ,Khoury W,Gu J,Shen B,Remzi FH,Hammel JP,Lavery IC,Fazio VW,Goldblum JR

    更新日期:2014-02-01 00:00:00

  • Fat induced jejunal inhibition of gastric acid secretion in duodenal ulcer patients before and after truncal vagotomy.

    abstract::The effect of intrajejunal infusion of a fat solution on pentagastrin-stimulated (0.5 microgram/kg-hr) gastric acid secretion was studied in five duodenal ulcer patients before and three to five months after truncal vagotomy. Preoperatively mean acid output was reduced from 41 +/- 5.2 meq H+/hr to 15.4 +/- 1.3 meq H+/...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197711000-00005

    authors: Christiansen J

    更新日期:1977-11-01 00:00:00

  • Combined Mechanical and Oral Antibiotic Bowel Preparation Reduces Incisional Surgical Site Infection and Anastomotic Leak Rates After Elective Colorectal Resection: An Analysis of Colectomy-Targeted ACS NSQIP.

    abstract:OBJECTIVE:To determine the association between preoperative bowel preparation and 30-day outcomes after elective colorectal resection. METHODS:Patients from the 2012 Colectomy-Targeted American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database who underwent elective colorectal rese...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000001041

    authors: Scarborough JE,Mantyh CR,Sun Z,Migaly J

    更新日期:2015-08-01 00:00:00

  • Primary Open Versus Closed Implantation Strategy for Totally Implantable Venous Access Ports: The Multicentre Randomized Controlled PORTAS-3 Trial (DRKS 00004900).

    abstract:OBJECTIVES:PORTAS-3 was designed to compare the frequency of pneumothorax or haemothorax in a primary open versus closed strategy for port implantation. BACKGROUND DATA:The implantation strategy for totally implantable venous access ports with the optimal benefit/risk ratio remains unclear. METHODS:PORTAS-3 was a mul...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003705

    authors: Hüttner FJ,Bruckner T,Hackbusch M,Weitz J,Bork U,Kotschenreuther P,Heupel O,Kümmel S,Schlitt HJ,Mattulat M,Pintér L,Seiler CM,Gutt CN,Nottberg HS,Pohl A,Ghanem F,Meyer T,Imdahl A,Neudecker J,Müller VA,Gehrig T,R

    更新日期:2020-12-01 00:00:00

  • Mild hypothermia provides significant protection against ischemia/reperfusion injury in livers of obese and lean rats.

    abstract:OBJECTIVE:To evaluate the effect of anesthesia induced mild systemic hypothermia on hepatic injury in lean and obese rats during warm ischemia. SUMMARY BACKGROUND DATA:Hepatic warm ischemia during surgery remains a significant problem, particularly in organs with presumed baseline dysfunction. METHODS:The left and me...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000154259.73060.f1

    authors: Choi S,Noh J,Hirose R,Ferell L,Bedolli M,Roberts JP,Niemann CU

    更新日期:2005-03-01 00:00:00

  • The relationship between extent of thyroid cancer surgery and use of radioactive iodine.

    abstract:UNLABELLED:By linking surgeon surveys to the National Cancer Database, we found that surgeons' tendency to perform more extensive thyroid resection is associated with greater use of radioactive iodine for stage I thyroid cancer. OBJECTIVE:To determine the relationships between surgeon recommendations for extent of res...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31826c8915

    authors: Haymart MR,Banerjee M,Yang D,Stewart AK,Doherty GM,Koenig RJ,Griggs JJ

    更新日期:2013-08-01 00:00:00

  • Five to twenty year followup after surgery for chronic pancreatitis in 148 patients.

    abstract::One-hundred and forty eight patients operated upon for chronic pancreatitis were reviewed retrospectively in 5-20 year followup. Treatment was by drainage of the duct of Wirsung to adefunctionalized jejunal loop, distal pancreatectomy, pancreato-duodenectomy, splanchnicectomy with an operative mortality of 5%. Influen...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197408000-00010

    authors: Leger L,Lenriot JP,Lemaigre G

    更新日期:1974-08-01 00:00:00

  • Overestimation of hereditary breast cancer risk.

    abstract:OBJECTIVE:To find out how women with breast or ovarian cancer rate their chances of carrying hereditary factors for these cancers and to determine the extent to which they overestimate their risk. SUMMARY BACKGROUND DATA:BRCA1 and BRCA2 are genes that cause breast and ovarian cancer when they are inherited in families...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199809000-00010

    authors: Iglehart JD,Miron A,Rimer BK,Winer EP,Berry D,Shildkraut MJ

    更新日期:1998-09-01 00:00:00

  • Outcomes of Posterior Component Separation With Transversus Abdominis Muscle Release and Synthetic Mesh Sublay Reinforcement.

    abstract:OBJECTIVE:To evaluate the safety and efficacy of transversus abdominis muscle release (TAR) with retrorectus synthetic mesh reinforcement in a large series of complex hernia patients. BACKGROUND:Posterior component separation via TAR during abdominal wall reconstruction (AWR) continues to gain popularity. Although our...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000001673

    authors: Novitsky YW,Fayezizadeh M,Majumder A,Neupane R,Elliott HL,Orenstein SB

    更新日期:2016-08-01 00:00:00

  • Sampling procedures in estrogen receptor determinations.

    abstract::To determine the significance of proteolysis and delayed freezing of tumor samples on estrogen receptor levels, values from 19 of 31 biopsy specimens were compared with that in remaining tumor at the completion of mastectomy. There was a 15-100% decrease in receptor content. Time-decay studies on selected postmastecto...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198105000-00003

    authors: Newsome JF,Avis FP,Hammond JE,Sherwood S

    更新日期:1981-05-01 00:00:00

  • Exclusion of nonisolated splenic vein in distal splenorenal shunt for prevention of portal malcirculation.

    abstract::In an attempt to prevent portoprival malcirculation after distal splenorenal shunt (DSRS), a splenic hilar renal shunt (HRS) with proximal flush ligation of splenic vein was designed. To accomplish this procedure, two methods were compared: HRS alone (Group A) and HRS plus proximal flush ligation of the splenic vein (...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198412000-00007

    authors: Inokuchi K,Beppu K,Koyanagi N,Nagamine K,Hashizume M,Sugimachi K

    更新日期:1984-12-01 00:00:00

  • One thousand liver transplants. The lessons learned.

    abstract:OBJECTIVE:To evaluate the first 1000 liver transplants performed at UCLA Medical Center to determine factors responsible for improved results. SUMMARY BACKGROUND DATA:Liver transplant has evolved impressively since the first case was performed in 1963. The 1980s have highlighted this progress with the development of b...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199405000-00007

    authors: Busuttil RW,Shaked A,Millis JM,Jurim O,Colquhoun SD,Shackleton CR,Nuesse BJ,Csete M,Goldstein LI,McDiarmid SV

    更新日期:1994-05-01 00:00:00

  • Staging laparotomy in Hodgkin's disease.

    abstract::Staging laparotomy (multiple liver and lymph node biopsies and splenectomy) was performed at the North Carolina Baptist Hospital in 123 patients with Hodgkin's disease. There were no deaths. Wound, pulmonary, intra-abdominal or urinary tract complications developed in 17 patients. Of those complications, one case each...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198005000-00008

    authors: Sterchi JM,Myers RT

    更新日期:1980-05-01 00:00:00

  • Use of transcutaneous oxygen sensors to titrate PEEP.

    abstract::The relationship of transcutaneous oxygen tension (PtcO2) to arterial oxygen tension (PaO2), pulmonary shunt (Qsp/Qt), mixed venous oxygen tension (PVO2), and O2 delivery was determined in patients with respiratory failure in order to explore the possible usefulness of PtcO2 to titrate the level of positive end expira...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198102000-00014

    authors: Tremper KK,Waxman K,Shoemaker WC

    更新日期:1981-02-01 00:00:00

  • Microwave ablation for hepatic malignancies: a multiinstitutional analysis.

    abstract:OBJECTIVE:This study hypothesized that tumor size, number of tumors, surgical approach, and tumor histology significantly affected microwave ablation (MWA) success and recurrence-free survival. BACKGROUND:Although many hepatobiliary centers have adopted MWA, the factors that influence local control are not well descri...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/SLA.0000000000000234

    authors: Groeschl RT,Pilgrim CH,Hanna EM,Simo KA,Swan RZ,Sindram D,Martinie JB,Iannitti DA,Bloomston M,Schmidt C,Khabiri H,Shirley LA,Martin RC,Tsai S,Turaga KK,Christians KK,Rilling WS,Gamblin TC

    更新日期:2014-06-01 00:00:00

  • Thymic neuroendocrine tumors: a SEER database analysis of 160 patients.

    abstract:INTRODUCTION:Thymic neuroendocrine tumors (NETs) are uncommon but malignant tumors of the thymus gland that are usually associated with systemic symptoms due to hypersecretion of biogenic amines from metastatic lesions. Due to the limited number of studies in the literature, very little is known about progress or trend...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3181dd4ec4

    authors: Gaur P,Leary C,Yao JC

    更新日期:2010-06-01 00:00:00

  • Significant contribution of the portal vein to blood flow through the common bile duct.

    abstract:OBJECTIVE:The aim of this study was to determine the contribution of the hepatic artery, gastroduodenal artery, and portal vein to the microvascular blood flow in the common bile duct (CBD). BACKGROUND:Biliary complications are a common cause of graft loss after liver transplantation. The occurrence is, partly, attrib...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31824714d0

    authors: Slieker JC,Farid WR,van Eijck CH,Lange JF,van Bommel J,Metselaar HJ,de Jonge J,Kazemier G

    更新日期:2012-03-01 00:00:00

  • Intestinal alkaline phosphatase prevents antibiotic-induced susceptibility to enteric pathogens.

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31828fae14

    authors: Alam SN,Yammine H,Moaven O,Ahmed R,Moss AK,Biswas B,Muhammad N,Biswas R,Raychowdhury A,Kaliannan K,Ghosh S,Ray M,Hamarneh SR,Barua S,Malo NS,Bhan AK,Malo MS,Hodin RA

    更新日期:2014-04-01 00:00:00

  • Transvaginal natural orifice translumenal endoscopic surgery cholecystectomy: early evolution of the technique.

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    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章

    doi:10.1097/SLA.0b013e3181a802e2

    authors: Gumbs AA,Fowler D,Milone L,Evanko JC,Ude AO,Stevens P,Bessler M

    更新日期:2009-06-01 00:00:00

  • Isolated gastrocnemius and soleal vein thrombosis: should these patients receive therapeutic anticoagulation?

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    journal_title:Annals of surgery

    pub_type: 杂志文章

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    更新日期:2010-04-01 00:00:00

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    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31822c5878

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    更新日期:2011-09-01 00:00:00

  • Pancreatectomy in multiple endocrine neoplasia type 1-related gastrinomas and pancreatic endocrine neoplasias.

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000218073.77254.62

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    更新日期:2006-07-01 00:00:00

  • Aneurysm of the aorta treated by wiring: case report of a 38-year survival.

    abstract::A patient with a syphilitic aneurysm of the aorta treated by the insertion of wire is presented. The patient remained well for almost 40 years, but finally succumbed after rupture. The autopsy findings are discussed. To our knowledge, this represents the longest reported survival after treatment of an aortic aneurysm ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197612000-00014

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    更新日期:1976-12-01 00:00:00

  • NF-kappaB activation in esophageal adenocarcinoma: relationship to Barrett's metaplasia, survival, and response to neoadjuvant chemoradiotherapy.

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    pub_type: 杂志文章

    doi:10.1097/01.sla.0000118751.95179.c6

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    更新日期:2004-04-01 00:00:00

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    pub_type: 杂志文章

    doi:10.1097/00000658-198412000-00019

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    更新日期:1982-06-01 00:00:00

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    pub_type: 杂志文章

    doi:10.1097/00000658-199505000-00006

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    更新日期:1995-05-01 00:00:00

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    pub_type: 杂志文章

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    authors: Fong Y,Wagman L,Gonen M,Crawford J,Reed W,Swanson R,Pan C,Ritchey J,Stewart A,Choti M

    更新日期:2006-06-01 00:00:00

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    更新日期:2018-04-01 00:00:00