Khirurgicheskaya taktika pri povrezhdeniyakh obodochnoy kishki v dorozhnotransportnykh proisshestviyakh (obzor literatury) [Surgical tactics in injuries of the colon in traffic accidents (literature review)]
https://doi.org/10.25016/2541-7487-2014-0-1-23-30
Abstract
According to WHO, every year road traffic accidents (RTA) globally kill nearly 1.2 million people, including more than 26 thousand peoples in Russia, and 20-50 million people are injured, in Russia - 270 thousand people. Surgical tactics in colon injuries (CI) in RTA victims remains an urgent problem in the daily work of emergency surgeons because of the increasing traffic trauma, high incidence of postoperative complications and high mortality. In the overall structure of abdominal injuries, CIs rank 3rd - 4th and are observed in 4-17 % of cases and 2.9 times less than small intestine injuries due to a more favorable anatomic location; usually, more serious traumatic effects on the body from the outside cause CIs. Therefore, 70-89 % of CIs are multiple or combined. Frequency of colon lesions varies in different colon segments because of their anatomical location, as described in the literature. Most often transverse colon is damaged (45-60 % of cases), then sigmoid colon (11.5 %) and the descending colon (8.7 % of cases). High frequency of postoperative complications from 20.4 to 67.1 % is typical for CIs, share of intra-abdominal complications account for 50 to 72 %, primarily due to intestinal sutures failure reaching 69 %. Abdominal sepsis was observed in 4.0-6.35 %, surgical wound festering - in 6-33 %. The mortality rate in the postoperative period according to various sources is 13.7-41.4 %. The main causes of death were peritonitis, shock, pneumonia and concomitant severe brain injury. The paper analyzes current problems in the diagnosis and surgical tactics, taking into account the severity of the trauma and the main factors influencing the choice; the focus is on the issues which need further assessment.
About the Authors
A. V. Kochetkov
The Nikiforov Russian Center of Emergrency and Radiation Medicine, EMERCOM of Russia
Russian Federation
Dr. Med. Sci. Prof.
Russian Federation
Dr. Med. Sci. Prof.
D. V. Dvoryankin
The Nikiforov Russian Center of Emergrency and Radiation Medicine, EMERCOM of Russia
Russian Federation
Dr. Med., PhD
Russian Federation
Dr. Med., PhD
A. V. Fedulova
The Nikiforov Russian Center of Emergrency and Radiation Medicine, EMERCOM of Russia
Russian Federation
Aspirant
Russian Federation
Aspirant
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For citations:
Kochetkov A.V., Dvoryankin D.V., Fedulova A.V. Khirurgicheskaya taktika pri povrezhdeniyakh obodochnoy kishki v dorozhnotransportnykh proisshestviyakh (obzor literatury) [Surgical tactics in injuries of the colon in traffic accidents (literature review)]. Medicо-Biological and Socio-Psychological Problems of Safety in Emergency Situations. 2014;(1):23-30. (In Russ.) https://doi.org/10.25016/2541-7487-2014-0-1-23-30
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