Abdominal Key

Fig. 2.1 Patients presenting with a large truncal defect in the right upper quadrant/right lower chest from a close-range shotgun blast or rifle wound (a) should be explored by an…

Fig. 5.1 Patient that sustained a close range shotgun blast with an AAST-OIS grade V hepatic injury and significant loss of the abdominal wall. Patient was rapidly transported to the…

Fig. 16.1 This figure shows a complex, stellate hepatic fracture within the interlobar plane between the gallbladder bed and inferior vena cava in a high-fidelity surgical simulator. Hepatic venous bleeding…

Fig. 10.1 CT scan of a 17-year-old boy with near traumatic liver resection. In this case, you may need to complete the liver resection on the initial operation Fig. 10.2…

Grade Injury description I Hematoma Subcapsular, <10 % surface area Laceration Capsular tear, <1 cm parenchymal depth II Hematoma Subcapsular, 10–50 % surface area; intraparenchymal, <10 cm diameter Laceration 1–3…

Reoperation mandatory  External drainage  End-tube hepatodochostomy or choledochostomy Reoperation not always necessary  T-tube or stent with limb beneath injury From Feliciano [9], Copyright Elsevier 1994 In patients with multiple intra-abdominal…

Fig. 3.1 The Mattox maneuver of left-sided visceral rotation to expose the proximal abdominal aorta Alternatively, the aorta may be approached through the lesser sac. The lesser omentum is widely…

Fig. 14.1 Admission CT scan of a 39-year-old man, after hepatorrhaphy, with an extensive injury to the right liver. Right hepatic artery clipping and tube cholecystostomy were previously done at…

Fig. 11.1 Omental pack. A graft of viable omentum is pulled through the penetrating tract in the liver Penrose pack. Described by Bluett et al. [4], it involves using a…

Fig. 4.1 Positive FAST showing fluid in the hepatorenal space In patients with penetrating trauma, FAST is less sensitive, and a negative FAST should not be used as the sole…