Blunt Trauma

Computed tomography scan is the mode of choice in evaluating the hemodynamically stable patient with blunt trauma.

Certain circumstances have been described in which computed tomography scan results cannot completely rule out abdominal organ injury. For example, patients with pelvic fractures or retroperitoneal hematomas, who already have abdominal tenderness (thereby limiting clinical evaluation), are at increased risk for missed blunt hollow organ injury. Similarly, such occult findings may also exist in patients who suffer head or spinal cord injury. Although diagnostic peritoneal lavage, ultrasound, or repeat computed tomography scan may detect the injury, early laparoscopy establishes the diagnosis, thus allowing for earlier definitive treatment.

Some urologic injuries can be diagnosed and treated laparoscopically. In patients with blunt trauma to the abdomen consisting of an isolated bladder injury, one can laparoscopically evaluate the bladder and repair the injury with intracorporeal suturing techniques.

Furthermore, in a similar manner, patients with isolated ureteral injury can also be managed laparoscopically, usually with repair over a ureteral stent. When laparoscopy is used in the evaluation of gunshot wounds, any trajectory traveling close to the path of the ureter should be evaluated and explored laparoscopically to rule out injury. A final use of laparoscopy in urologic trauma is in performing planned laparo-scopic nephrectomy for the management of the delayed atrophic traumatic kidney or for refractory renal hypertension secondary to renal arterial injury.

Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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