Published online Jun 25, 1996. doi: 10.3748/wjg.v2.i2.99
Revised: February 2, 1996
Accepted: April 10, 1996
Published online: June 25, 1996
AIM: To summarize our experience in diagnosis and treatment of 119 patients with traumatic visceral rupture.
METHODS: One-hundred-and-twenty-two patients (21 women and 101 men, with an average age of 44.75 years) were studied. The causes of injury included bullet wound, stabbing wound, falling from building, traffic accident, etc. First, more than 2 intravenous transfusion pathways were set up immediately, and pre-operative preparations were made as quickly as possible. The patient was put immediately under monitoring in the ICU. Then, emergency explorative surgery was carried out to stop the bleeding and repair the ruptured viscera. In 20 patients with severe illness, the combined therapy of “Four High Doses in Large Volume and One Support” (FHDOS) was used, consisting of a short delivery period of high doses of anisodaminum in large volumes, a short delivery period of high doses of dexamethosone in large volumes, high doses of antibiotics in large volumes, high doses of abdominal cavity washing liquid in large volumes, and one nutritional support.
RESULTS: One-hundred-and-nineteen patients recovered after the active treatment and 3 patients died. The mortality rate was 2.5%.
CONCLUSION: Diagnosis and treatment should be quick, decisive, correct and rational. It is imperative to keep the respiratory tract unobstructed and to treat shock. Abdominal explorative surgery should be carried out to stop bleeding and repair ruptured viscera simultaneously. Efforts should be made to avoid misdiagnosis and ICU monitoring provides significant benefit to the patient. The new treatment method of FHDOS is simple, practical and effective for critically ill patients, and it plays a key role in treating multiple organ failure.