Abstract

ASENSIO, Juan A et al. Lesiones vasculares abdominales: El desafío del cirujano de trauma. Acta méd. costarric [online]. 2001, vol.43, n.2, pp.55-63. ISSN 0001-6002.

Aim: Abdominal vascular injuries have a very high mortality and morbidity rates among trauma patients. Methods: This is a clinical review of the diagnosis, surgical procedures, and treatment of patients with abdominal vascular injuries, based on the clinical experience from 302 patients presenting this type of injury. Results: Penetrating injuries account for 90% to 95% of all abdominal vascular injuries. Mutiple organ injuries are frequent. The clinical sings of a hemoperitoneum and or peritonitis and the absence of femoral pulses are indications for laparatomy. In the patients with cardio-pulmonary arrest, an emergent thoracatomy with open cardiac mássage and cross clamping of the aorta should be performed. The global mortality rate is 54%. Exsanguination accounts for 85% of these deaths. The compartment syndrome of the abdomen and limbs, as well as the cronic cycle of ascidosis, hypothermia, and coagulopathies are the principle complications. Conclusions: Abdominal vascular injuries have a high mortality/morbidity rate. The precise knowledge of the retroperitoneal anatomy and the surgical approaches to access these vessels, as well as the adequate clinical evaluation will assist in lowering the mortality and complications rates of these patients.

Keywords : Abdominal vascular injuries; diagnosis; surgical procedures.