ObjectiveTo investigate the clinical features and strategy of diagnosis and treatment of the abdominal trauma in elder people. MethodsClinical data of 68 elderly patients with abdominal trauma were analyzed retrospectively.ResultsDiagnosis in 35 of 68 cases were confirmed within 12 hours after trauma (51.5%). Fiftyeight cases in this group were treated surgically and 10 cases with nonsurgical treament.There were 7 death, the overall mortality was 10.3%. The cause of death was septic shock and multiple organ systemic failure. ConclusionThe elder patient with abdominal trauma has its speciality in clinical and pathophysiological characteristics and is less tolerant to trauma, which easily leads to misdiagnosis or maldiagnosis. The principle of treatment is to choose positive surgery, to streng then the perioperative management, to protect the function of each important organ, and to prevent the occurrence of multiple organ dysfunction syndrome.
ObjectiveTo explore the diagnostic and therapeutic significance of laparoscopic surgery for abdominal trauma patients. MethodsClinical data of 65 patients with abdominal trauma who treated in Affiliated Laigang Hospital of Taishan Medical College from January 2010 to December 2014 were collected retrospectively, all patients were diagnosed by laparoscopic exploration, and therapies were depended on the results of laparoscopic exploration. ResultsOf the 65 patients, 60 patients were definitely diagnosed through laparoscopic exploration, but 5 patients transferred to laparotomy because of clear diagnosis was not achieved under laparoscopy. Of the 60 patients who were diagnosed clearly by laparoscopy, 23 patients didn't received any intervention because of no obvious injury observed, 27 patients received laparoscopic surgery (3 patients were assisted with hands), and 10 patients transferred to open operation because of peritoneal contamination. Incision infection occurred in 1 patient after operation, 1 patient suffered from subphrenic abscess, and other 63 patients didn't suffered from any complication. All of the patients were discharged successfully. All of the 65 patients were followed up for 2-48 months with the median time of 10 months. Severe complications did not occurred and no patient needed re-operation within the period of follow-up period. ConclusionsLaparoscopy is feasible, safe, and effective for the evaluation and treatment of abdominal trauma patients with stable hemodynamics, and it also has a higher diagnostic rate. Laparoscopy can also reduce the negative exploratory laparotomy for the abdominal trauma patients.