TY - JOUR
T1 - Lessons learned in the management of thirteen celiac axis injuries
AU - Asensio, Juan A.
AU - Petrone, Patrizio
AU - Kimbrell, Brian
AU - Kuncir, Eric
PY - 2005/4/1
Y1 - 2005/4/1
N2 - Objectives: Celiac axis injuries are rare. The purposes of this study were to (1) review institutional experience, (2) determine additive effect on death of associated vessel injuries, and (3) correlate mortality rates with the American Association for the Surgery of Trauma-Organ Injury Scale (AAST-OIS) for abdominal vascular injury. Methods: This was a retrospective, 132-month study (January 1992 to December 2002) of patients with celiac axis injuries. Results: Thirteen patients were included in the study. Mean revised trauma score was 5.35 ±2.63; mean injury severity score was 25 ± 12. The mechanism was penetrating in 12 (92%) and blunt in 1 (8%); 3 of 13 had Emergency Department thoracotomy (100% mortality rate). Treatment included ligation in 11 and primary repair in 1; 1 exsanguinated. Overall survival was 5 of 13 (38%). Adjusted survival excluding patients who had Emergency Department thoracotomy was 5 of 10 patients (50%). Those surviving with isolated injuries included 57% of patients. Mortality rate versus AAST-OIS was grade III, 43% (3 of 7 patients); grade IV, 50% (1 of 2 patients); and grade V, 100% (4 of 4 patients). Conclusions: Celiac axis injuries are rare. Patients with isolated injuries have better survival rates. Mortality rate correlates well with AAST-OIS for abdominal vascular injury.
AB - Objectives: Celiac axis injuries are rare. The purposes of this study were to (1) review institutional experience, (2) determine additive effect on death of associated vessel injuries, and (3) correlate mortality rates with the American Association for the Surgery of Trauma-Organ Injury Scale (AAST-OIS) for abdominal vascular injury. Methods: This was a retrospective, 132-month study (January 1992 to December 2002) of patients with celiac axis injuries. Results: Thirteen patients were included in the study. Mean revised trauma score was 5.35 ±2.63; mean injury severity score was 25 ± 12. The mechanism was penetrating in 12 (92%) and blunt in 1 (8%); 3 of 13 had Emergency Department thoracotomy (100% mortality rate). Treatment included ligation in 11 and primary repair in 1; 1 exsanguinated. Overall survival was 5 of 13 (38%). Adjusted survival excluding patients who had Emergency Department thoracotomy was 5 of 10 patients (50%). Those surviving with isolated injuries included 57% of patients. Mortality rate versus AAST-OIS was grade III, 43% (3 of 7 patients); grade IV, 50% (1 of 2 patients); and grade V, 100% (4 of 4 patients). Conclusions: Celiac axis injuries are rare. Patients with isolated injuries have better survival rates. Mortality rate correlates well with AAST-OIS for abdominal vascular injury.
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U2 - 10.1097/01.SMJ.0000136239.16913.C2
DO - 10.1097/01.SMJ.0000136239.16913.C2
M3 - Review article
C2 - 15898524
AN - SCOPUS:17244363151
VL - 98
SP - 462
EP - 466
JO - Southern Medical Journal
JF - Southern Medical Journal
SN - 0038-4348
IS - 4
ER -