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Journal of Education, Health and Sport

Optimization of diagnostics of combat injuries of the abdomen
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Optimization of diagnostics of combat injuries of the abdomen

Authors

  • O. S. Herasymenko Military Medical Clinical Center of the Southern Region
  • V. Y. Shapovalov Military Medical Clinical Center of the Southern Region
  • R. V. Yenin Military Medical Clinical Center of the Southern Region
  • M. A. Koshikov Military Medical Clinical Center of the Southern Region
  • Y. I. Haida Military Medical Clinical Center of the Southern Region
  • S. D. Herasymenko Ukrainian Medical Dental Academy
  • K. R. Muradyan Military Medical Clinical Center of the Southern Region
  • A. V. Okolets Military Medical Clinical Center of the Southern Region

DOI:

https://doi.org/10.12775/JEHS.2021.11.04.003

Keywords

combat injuries of the abdomen, laparocentesis, videolaparoscopy, ultrasound.

Abstract

The aim - to optimize the diagnostic scheme for combat abdominal injuries at the II level of medical care by identifying the most informative and fast instrumental diagnostic methods.

A clinical and statistical analysis of the results of surgical treatment of 496 wounded with combat abdominal injuries treated in military mobile hospitals from June 2014 to August 2017 was carried out. Additional diagnostic tests were conducted for the injured with BPH in the comparison groups - FAST protocol, laparocentesis and diagnostic laparoscopy.

In the general array of the study (n = 496), the FAST protocol was performed by 208 wounded (41.9%), laparocentesis - 270 (54.4%), video laparoscopy - 103 (20.8%). The number of emergency ultrasound studies in the volume of the FAST protocol with combat abdominal injuries in group 1 was 19.2%, in group 2 - 40.7%, in group 3 - 66.5%. A more frequent FAST protocol for injured with BPG at level II of medical care in groups 2 and 3 resulted in a decrease in the number of laparocentesis performed from 68.3% (in group 1) to 38.6% (in group 3), and an increase in the number of video laparoscopic studies from 14.9% (in group 1) to 26.6% (in group 3), most of which turned into therapeutic laparoscopy.

The data obtained indicate that the widespread introduction of the FAST protocol into the PID diagnosis scheme at the II level of medical care helps to reduce the number of invasive (often unfounded) methods, namely, laparocentesis and diagnostic laparotomy, reduce the time spent on diagnosis and the choice of optimal surgical tactics.

References

E.V. Svitlychnyi, O.I. Hrechanyk. Ultrazvukova diahnostyka travmy ta yii uskladnen. – K.: SPD Chaplynska N.V., 2016. – 215 s. (in Ukrainian).

I.P. Khomenko, E.V. Svitlychnyi, O.I. Hrechanyk, O.M. Melnyk, B.A. Tarasiuk, K.R. Muradian. Ekstreni ultrazvukovi doslidzhennia pry travmi FAST-protokol. – Kyiv: «Vydavnytstvo Liudmyla», 2018. – 66 s. (in Ukrainian).

Chestovich PJ, Browder TD, Morrissey SL, Fraser DR, Ingalls NK, Fildes JJ. Minimally invasive is maximally effective: diagnostic and therapeutic laparoscopy for penetrating abdominal injuries. J Trauma Acute Care Surg. 2015;78: 1076–1085. doi: 10.1097/TA.0000000000000655.

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Koto MZ, Matsevych OY, Motilall SR. The role of laparoscopy in penetrating abdominal trauma: our initial experience. J Laparoendosc Adv Surg Tech A. 2015;25: 730–736. doi: 10.1089/lap.2015.0042.

Lee PC, Lo C, Wu JM, Lin KL, Lin HF, Ko WJ. Laparoscopy decreases the laparotomy rate in hemodynamically stable patients with blunt abdominal trauma. Surg Innov. 2014;21: 155–165. doi: 10.1177/1553350612474496

Lin HF, Chen YD, Lin KL, Wu MC, Wu CY, Chen SC. Laparoscopy decreases the laparotomy rate for hemodynamically stable patients with blunt hollow viscus and mesenteric injuries. Am J Surg. 2015;210: 326–333. doi: 10.1016/j.amjsurg.2014.11.009

Lin HF, Wu JM, Tu CC, Chen HA, Shih HC. Value of diagnostic and therapeutic laparoscopy for abdominal stab wounds. World J Surg. 2010;34: 1653–1662. doi: 10.1007/s00268-010-0485-5.

Nicolau AE. Is laparoscopy still needed in blunt abdominal trauma? Chirurgia (Bucur). 2011;106: 59–66.

Uranues S, Popa DE, Diaconescu B, Schrittwieser R. Laparoscopy in penetrating abdominal trauma. World J Surg. 2015;39: 1381–1388. doi: 10.1007/s00268-014-2904-5.

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Published

2021-04-13

How to Cite

1.
HERASYMENKO, O. S., SHAPOVALOV, V. Y., YENIN, R. V., KOSHIKOV, M. A., HAIDA, Y. I., HERASYMENKO, S. D., MURADYAN, K. R. and OKOLETS, A. V. Optimization of diagnostics of combat injuries of the abdomen. Journal of Education, Health and Sport. Online. 13 April 2021. Vol. 11, no. 4, pp. 28-36. [Accessed 7 July 2025]. DOI 10.12775/JEHS.2021.11.04.003.
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Vol. 11 No. 4 (2021)

Section

Research Articles

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