Etiology: as rupture spleen
Management:
(I) Rapid evaluation.
(II) Resuscitation.
(III) Review
(IV) Radiology and other investigation
[(I, II, III, IV) See resuscitation of the acutely injured patient].
(V) Repair
1) Rupture spleen: see before.
2) Liver injury: see before.
3) Rupture gut: Explore:
1- Small intestine, if small tear suture it by transverse sutures in two layers. First layer is continuos catgut layer for haemostasis. The second layer is continues seromuscular layer by silk for sealing of anastomotic line. In lacerations do resection anastomasis.
2- Stomach, suture it in two layers.
3- Colon,
A) Rt side: 1ry repair in two layers as small intestine can be done.
B)Lt. side: Do proximal coloslomy and repair the tear in one layer of silk. suture .
4- Pancreas: Suture by silk suture and put drain in the lesser sac in cases of severe damage partial pancreatectomy may be needed.
5- Kidney: see renal trauma.
SOURCE: DR. AYMAN SALEM'S BOOK
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