July 8, 2009 | In: TRAUMA
29 PELVIC FRACTURES Steven J. Morgan M.D., Wade R. Smith M.D. 1. What are the first steps in the evaluation and treatment of a patient with pelvic trauma? Show answer The ABCs (airway, breathing, and circulatory assessment). The answer to...
July 7, 2009 | In: TRAUMA
RECTAL TRAUMA 9. How do rectal injuries occur? Show answer Similar to colon injuries, most rectal injuries result from penetrating trauma. Blunt pelvic fractures should be assessed with a strong suspicion for rectal (and urethral)...
July 7, 2009 | In: TRAUMA
28 TRAUMA TO THE COLON AND RECTUM W. Andrew Lawrence M.D., Jon M. Burch M.D. COLON TRAUMA 1. How do most colon injuries occur? Show answer Nearly all (> 95%) colon injuries are caused by penetrating trauma from gunshot, stab, iatrogenic,...
July 7, 2009 | In: TRAUMA
27 PANCREATIC AND DUODENAL INJURY Caesar M. Ursic M.D. 1. How common are pancreatic injuries? Show answer The pancreas is not commonly injured because of its protected retroperitoneal position, and thus accounts for only 8% of all...
July 7, 2009 | In: TRAUMA
26 SPLENIC TRAUMA David J. Ciesla M.D., Ernest E. Moore M.D. 1. What is the physiologic role of the spleen? Show answer In fetal development, the spleen serves as a major site for hematopoiesis. In early childhood the spleen produces...
July 7, 2009 | In: TRAUMA
BILIARY TRACT INJURY 22. Why are complications associated with bile duct leaks? Show answer Bilomas (i.e., collections of bile) frequently become infected and may result in lethal peritonitis. Biliopleural fistula, a communication between the...
July 7, 2009 | In: TRAUMA
OPERATIVE MANAGEMENT OF LIVER INJURY 11. How are acute liver injuries classified? Show answer Liver wounds are generally graded on a scale of I to VI according the depth of parenchymal laceration and involvement of the hepatic veins or...
July 7, 2009 | In: TRAUMA
SURGICAL ANATOMY OF THE LIVER 7. How many anatomic lobes are present in the liver? What is their topographic boundary? Show answer The liver is divided into two anatomic lobes, the right and the left. Their boundary lies in an oblique plane...
July 7, 2009 | In: TRAUMA
25 HEPATIC AND BILIARY TRAUMA Reginald J. Franciose M.D., Ernest E. Moore M.D. 1. How often is the liver injured in trauma? Show answer The liver is both big and central, so it is an easy target. 2. Do the liver and spleen respond...
July 7, 2009 | In: TRAUMA
CONTROVERSY 14. What is the role of laparoscopy and thoracoscopy after penetrating abdominal trauma? Show answer Although an intriguing diagnostic modality with additional therapeutic capabilities, laparoscopy thus far appears to have limited...
July 7, 2009 | In: TRAUMA
24 PENETRATING ABDOMINAL TRAUMA Clay Cothren M.D., Ernest E. Moore M.D. 1. Why is there a different approach to stab and gunshot wounds? Show answer Whereas one third of stab wounds to the anterior abdomen do not penetrate the peritoneum,...
July 7, 2009 | In: TRAUMA
23 BLUNT ABDOMINAL TRAUMA David J. Ciesla M.D., Ernest E. Moore M.D. 1. What elements of the history are important in evaluating a patient with suspected blunt abdominal trauma (BAT)? Show answer First, the mechanism of injury (e.g., motor...
July 7, 2009 | In: TRAUMA
22 PENETRATING THORACIC TRAUMA Jeffrey L. Johnson M.D., Ernest E. Moore M.D. 1. How often do patients with penetrating chest wounds need an operation? Show answer Surprisingly rarely. Most civilian penetrating injuries are from knives and...
July 7, 2009 | In: TRAUMA
21 BLUNT THORACIC TRAUMA Jeffrey L. Johnson M.D., Ernest E. Moore M.D. 1. How often do patients with isolated blunt chest trauma need an emergent operation? Show answer Rarely. In patients who arrive in the hospital alive, operative...
July 7, 2009 | In: TRAUMA
20 PENETRATING NECK TRAUMA Clay Cothren M.D., Ernest E. Moore M.D. 1. Why are penetrating neck wounds unique? Show answer Although comprising only a small percentage of body surface area, the neck contains a heavy concentration of vital...