Abdomnial vascular injuries

الملخص EN

This study a review of 64-patients with abdominal vascular injuries from January 2007 to December 2013.Where treated in the emergency department of the cardiothoracic and vascular surgery.

Most of them young age 18-50years,average age(32years).Male 46-patients,female 18-patients.Penetrating injuries (45-cases 70.2 %),blunt injury (3-cases 4.8 %), accidental (16-cases 25 %).Penetrating injuries(blast/shell injury 30- cases,gunshot 12-cases, stab wound 3-cases).Zone I (44-cases), zone II(4-cases), zone III (16-cases).According to organ injury scale Grade IV most common(38-patients 59.37 %).

Aortic artery injury 28-cases.

Inferior vena cava(8-cases) combined injury with aorta (20-cases),renal artery(4), splenic artery(2), celiac trunk (6),left common iliac artery (3), external and internal iliac arteries (13).

Small bowel injuries (12-cases),large bowel(6),spleen(2),renal(4),liver(8),ureter, bladder (7).

Ligation(19-cases 29.68 %),direct repair or by graft (49- cases 76.56 %).Complication ongoing bleeding 7.81%, respiratory distress 15..62 %, wound dehiscence 9.37 %.

Mortality rate (12) 18.75 %, survival rate(52) 81.25 %.Coagulopathy, metabolic acidosis, hypothermia,combined vascular injuries ,and associated abdominal organs injuries increase the morbidity and mortality rates.

Trauma surgeon should had a back-ground of the abdominal vascular anatomy ,and the methods of the vascular anastomosis.

Primary goal control of the bleeding rather than maintenance of the blood flow to the organs.