IMPLEMENTATION OF INTRAOPERATIVE COLONOSCOPY (IOC) FOR DIAGNOSIS OF MODERN GUNSHOT COLON PENETRATING WOUNDS AT THE ROLE 2 OF MEDICAL SUPPORT
EAES Academy. Popova O. 07/05/22; 366549; P292
Oksana Popova
Contributions
Contributions
Abstract
Introduction. Gunshot wounds of the colon are the most severe injuries of the abdominal cavity and are characterized by a large number of complications and high mortality, it is about 26.7%. In modern conditions, the problem of diagnosis gunshot wounds of the colon remains relevant, especially its mesoperitoneal part, when during laparotomy it is impossible to diagnose minor penetrating injuries (grades 1-2 according to AAST). With untimely diagnosis, such injuries in the postoperative period causes to severe and often fatal infection complications.
The aim is to improve the diagnosis of gunshot penetrating injuries of the colon in the wounded by using IOC at the Role 2 of military medical support.
Methods. At the Role 2 of medical support in military mobile hospitals located in the area of Operations of the Joint Forces at the East of Ukraine, 208 servicemen with gunshot penetrating wounds to the abdomen with damage to the colon were examined and operated on. The age of the wounded was from 18 to 55 years, on average (33.2±8.8). The presence of hemoperitoneum, subtly and thickly intestinal contents made it difficult to determine the topic of damage, so intraoperative colonoscopy was performed. Surgeon controlled the passage of the colonoscope through the parts of the intestine, air supply, luminescence and blood detection in the colon, which helped to quickly visualize the places of penetrating damage. Intraoperatively, these wounded were diagnosed with multiple gunshot shrapnel wounds of the colon of the 1-2 degrees according to AAST.
Results. IOC allowed to quickly and accurately establish the topographic and anatomical location of penetrating lesions in all 19 (9,1%) cases, in another 7 cases (not included to the group) it allowed to exclude damage to the colon. Injuries were distributed by localization as follows: cecum - 0, ascending part colon - 3 (15.85%), hepatic angle - 4 (21%), transverse colon - 3 (15.85%), splenic angle - 1 (5.3%), descending colon - 4 (21%), sigmoid colon - 4 (21%). Through wounds were found in 18 wounded (94.7%), blunt with a metal fragment inside the colon - in 1 (5.3%) case.
Conclusions. Performing intraoperative colonoscopy in wounded with gunshot wounds penetrated the abdomen in 19 (9.1%) cases allowed to clearly and quickly verify the damage to the colon and to establish the topographic and anatomical location of injuries, especially difficult to diagnose parts of the colon. In 7 cases (not included in the group) IOC allowed to exclude the damage to the colon. Visualization of multiple small lesions prevented the development of severe complications in the postoperative period. In 1 (5.3%) case, intraoperative colonoscopy allowed to remove a metal fragment from the colon during surgery. Intraoperative colonoscopy can be used for diagnose wounds with colon damage at the Role 2 of medical care - in military-mobile hospitals for rapid diagnosis of colon damage and their location, as well as prevention of complications associated with late diagnosis.
The aim is to improve the diagnosis of gunshot penetrating injuries of the colon in the wounded by using IOC at the Role 2 of military medical support.
Methods. At the Role 2 of medical support in military mobile hospitals located in the area of Operations of the Joint Forces at the East of Ukraine, 208 servicemen with gunshot penetrating wounds to the abdomen with damage to the colon were examined and operated on. The age of the wounded was from 18 to 55 years, on average (33.2±8.8). The presence of hemoperitoneum, subtly and thickly intestinal contents made it difficult to determine the topic of damage, so intraoperative colonoscopy was performed. Surgeon controlled the passage of the colonoscope through the parts of the intestine, air supply, luminescence and blood detection in the colon, which helped to quickly visualize the places of penetrating damage. Intraoperatively, these wounded were diagnosed with multiple gunshot shrapnel wounds of the colon of the 1-2 degrees according to AAST.
Results. IOC allowed to quickly and accurately establish the topographic and anatomical location of penetrating lesions in all 19 (9,1%) cases, in another 7 cases (not included to the group) it allowed to exclude damage to the colon. Injuries were distributed by localization as follows: cecum - 0, ascending part colon - 3 (15.85%), hepatic angle - 4 (21%), transverse colon - 3 (15.85%), splenic angle - 1 (5.3%), descending colon - 4 (21%), sigmoid colon - 4 (21%). Through wounds were found in 18 wounded (94.7%), blunt with a metal fragment inside the colon - in 1 (5.3%) case.
Conclusions. Performing intraoperative colonoscopy in wounded with gunshot wounds penetrated the abdomen in 19 (9.1%) cases allowed to clearly and quickly verify the damage to the colon and to establish the topographic and anatomical location of injuries, especially difficult to diagnose parts of the colon. In 7 cases (not included in the group) IOC allowed to exclude the damage to the colon. Visualization of multiple small lesions prevented the development of severe complications in the postoperative period. In 1 (5.3%) case, intraoperative colonoscopy allowed to remove a metal fragment from the colon during surgery. Intraoperative colonoscopy can be used for diagnose wounds with colon damage at the Role 2 of medical care - in military-mobile hospitals for rapid diagnosis of colon damage and their location, as well as prevention of complications associated with late diagnosis.
Introduction. Gunshot wounds of the colon are the most severe injuries of the abdominal cavity and are characterized by a large number of complications and high mortality, it is about 26.7%. In modern conditions, the problem of diagnosis gunshot wounds of the colon remains relevant, especially its mesoperitoneal part, when during laparotomy it is impossible to diagnose minor penetrating injuries (grades 1-2 according to AAST). With untimely diagnosis, such injuries in the postoperative period causes to severe and often fatal infection complications.
The aim is to improve the diagnosis of gunshot penetrating injuries of the colon in the wounded by using IOC at the Role 2 of military medical support.
Methods. At the Role 2 of medical support in military mobile hospitals located in the area of Operations of the Joint Forces at the East of Ukraine, 208 servicemen with gunshot penetrating wounds to the abdomen with damage to the colon were examined and operated on. The age of the wounded was from 18 to 55 years, on average (33.2±8.8). The presence of hemoperitoneum, subtly and thickly intestinal contents made it difficult to determine the topic of damage, so intraoperative colonoscopy was performed. Surgeon controlled the passage of the colonoscope through the parts of the intestine, air supply, luminescence and blood detection in the colon, which helped to quickly visualize the places of penetrating damage. Intraoperatively, these wounded were diagnosed with multiple gunshot shrapnel wounds of the colon of the 1-2 degrees according to AAST.
Results. IOC allowed to quickly and accurately establish the topographic and anatomical location of penetrating lesions in all 19 (9,1%) cases, in another 7 cases (not included to the group) it allowed to exclude damage to the colon. Injuries were distributed by localization as follows: cecum - 0, ascending part colon - 3 (15.85%), hepatic angle - 4 (21%), transverse colon - 3 (15.85%), splenic angle - 1 (5.3%), descending colon - 4 (21%), sigmoid colon - 4 (21%). Through wounds were found in 18 wounded (94.7%), blunt with a metal fragment inside the colon - in 1 (5.3%) case.
Conclusions. Performing intraoperative colonoscopy in wounded with gunshot wounds penetrated the abdomen in 19 (9.1%) cases allowed to clearly and quickly verify the damage to the colon and to establish the topographic and anatomical location of injuries, especially difficult to diagnose parts of the colon. In 7 cases (not included in the group) IOC allowed to exclude the damage to the colon. Visualization of multiple small lesions prevented the development of severe complications in the postoperative period. In 1 (5.3%) case, intraoperative colonoscopy allowed to remove a metal fragment from the colon during surgery. Intraoperative colonoscopy can be used for diagnose wounds with colon damage at the Role 2 of medical care - in military-mobile hospitals for rapid diagnosis of colon damage and their location, as well as prevention of complications associated with late diagnosis.
The aim is to improve the diagnosis of gunshot penetrating injuries of the colon in the wounded by using IOC at the Role 2 of military medical support.
Methods. At the Role 2 of medical support in military mobile hospitals located in the area of Operations of the Joint Forces at the East of Ukraine, 208 servicemen with gunshot penetrating wounds to the abdomen with damage to the colon were examined and operated on. The age of the wounded was from 18 to 55 years, on average (33.2±8.8). The presence of hemoperitoneum, subtly and thickly intestinal contents made it difficult to determine the topic of damage, so intraoperative colonoscopy was performed. Surgeon controlled the passage of the colonoscope through the parts of the intestine, air supply, luminescence and blood detection in the colon, which helped to quickly visualize the places of penetrating damage. Intraoperatively, these wounded were diagnosed with multiple gunshot shrapnel wounds of the colon of the 1-2 degrees according to AAST.
Results. IOC allowed to quickly and accurately establish the topographic and anatomical location of penetrating lesions in all 19 (9,1%) cases, in another 7 cases (not included to the group) it allowed to exclude damage to the colon. Injuries were distributed by localization as follows: cecum - 0, ascending part colon - 3 (15.85%), hepatic angle - 4 (21%), transverse colon - 3 (15.85%), splenic angle - 1 (5.3%), descending colon - 4 (21%), sigmoid colon - 4 (21%). Through wounds were found in 18 wounded (94.7%), blunt with a metal fragment inside the colon - in 1 (5.3%) case.
Conclusions. Performing intraoperative colonoscopy in wounded with gunshot wounds penetrated the abdomen in 19 (9.1%) cases allowed to clearly and quickly verify the damage to the colon and to establish the topographic and anatomical location of injuries, especially difficult to diagnose parts of the colon. In 7 cases (not included in the group) IOC allowed to exclude the damage to the colon. Visualization of multiple small lesions prevented the development of severe complications in the postoperative period. In 1 (5.3%) case, intraoperative colonoscopy allowed to remove a metal fragment from the colon during surgery. Intraoperative colonoscopy can be used for diagnose wounds with colon damage at the Role 2 of medical care - in military-mobile hospitals for rapid diagnosis of colon damage and their location, as well as prevention of complications associated with late diagnosis.
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