Serban I
Universitatea de Medicină "Gr.T. Popa" Iaşi, Facultatea de Medicină, Clinica Urgenţe Chirurgicale.
Rev Med Chir Soc Med Nat Iasi. 2006 Jan-Mar;110(1):157-60.
The authors present the case of a 21-years-old patient who was admitted in the hospital with a severe abdominal gunshot wound and hemorrhagic shock. Because of the gravity of the external bleeding and the severity of his general status he was admitted directly to the surgery room. The decision of surgical treatment was taken from the first look, so all the diagnostic maneuvers were taken in the surgery room at the same time with the preparations for general anesthesia and surgery, except for the clinical exam and preservation of blood and urine. The duration of the surgical operation was relatively short, almost 2 hours, compared with the visceral lesions identified and treated. The recovery was amazingly rapid, with no significant complications, the patient being discharged from the hospital after 17 days. This case has some particularities which can be discussed: immediate surgery is the only way to give a chance of survival in these kinds of situations; never loose time with other investigations; single gunshot wound of the abdomen determined 4 visceral lesions, every one of them being very severe; the patient had a very short period of recovery.
作者介绍了一名21岁患者的病例,该患者因严重腹部枪伤和失血性休克入院。由于外出血严重且全身状况不佳,他被直接送入手术室。从第一眼就做出了手术治疗的决定,所以除了临床检查以及保存血液和尿液外,所有诊断操作都在手术室与全身麻醉和手术准备同时进行。与所发现和治疗的内脏损伤相比,手术持续时间相对较短,几乎为2小时。恢复速度惊人地快,没有明显并发症,患者在17天后出院。该病例有一些特殊情况值得探讨:立即手术是这类情况下给予生存机会的唯一途径;不要在其他检查上浪费时间;腹部单发枪伤导致4处内脏损伤,每一处都非常严重;患者恢复时间很短。