1/2. Intestinal injuries in childhood: analysis of 32 cases.This is a retrospective study of 32 cases of intestinal injuries sustained among 135 children admitted from cases of abdominal trauma in 1976 till 1989. Falls from height or bullock cart and bull-gore injury formed the majority of the cases (21/32; 65%). Clinical thermometer accounted for perforating injuries in 2 neonates. Penetrating injury accounted for 10 cases and blunt trauma was responsible in 19. The site of injury was duodenum 1, jejunum 8, ileum 17, colon 3, rectum 4, and multiple sites 1. Associated injuries included diaphragmatic rupture 1, liver 1, mesentery 4, retroperitoneal hematoma 4, head injury 2, and loss of hand due to blast 1. diagnosis was made on history, physical examination, pneumoperitoneum in plain x-ray, and diagnostic four-quadrant peritoneal tap. Closure of perforations was done in 21 cases, wedge resection in 3, and resection anastomosis in 5. Protective colostomy had to be done in 5 cases. Four patients died of septicemia (2) and head injury (2).- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/2. Nonsurgical pneumoperitoneum: a case report and a review.The finding of extraluminal gas on plain radiographs is usually associated with a perforated viscus. But, as this case shows, the finding of pneumoperitoneum is not pathogenic of a perforated viscus or even of a surgical emergency, because there are many benign explanations for a pneumoperitoneum. Perhaps the most important maneuver for differentiating between the two is by performing a through history and physical examination. This in conjunction with either a diagnostic peritoneal lavage, contrast studies, or endoscopic evaluation can help prevent a patient from having needless surgery. The causes of a nonsurgical pneumoperitoneum are described as well as a treatment plan for patients presenting with a nonsurgical pneumoperitoneum.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |