ectes-2024-eposter-hintergrund-660bca90303c0212783071.jpg

ectes-2024-eposter-logo-660bcc1ca0874706891033.svg

ectes-2024-eposter-start-660bc6df45fbd927741591.jpg

23rd European Congress of Trauma & Emergency Surgery

Prof.

A comprehensive review of thoracic endovascular aortic repair for traumatic thoracic aortic injuries at a level 1 trauma center

Visceral trauma

Trauma and Emergency surgery | Miscellaneous

Introduction: This study evaluated TEVAR's role in treating thoracic aortic injuries, focusing on non-surgical treatments and intervention timings at our trauma center over a decade. It aims to understand disparities with current trends to enhance patient care. Material &amp; Methods: Between 2014-2023, 66 patients with thoracic aortic injuries were studied. The period was divided into two phases: 2014-2017 and 2018-2023. Patients were grouped by intervention timing (within or after 24 hours) and survival outcomes. Results: The use of β-blockers declined from 37.9% to 10.8%. Early interventions rose from 62.1% to 91.9%. Mortality increased slightly from 6.9% to 18.9%. The Injury Severity Score indicated more severe injuries in the latter phase. Significant disparities were noted in intervention timings for grade 3 and 4 injuries. Non-survivors had shorter ER to intervention times and higher injury severity. Conclusions: Even with more interventional radiologists and evolving strategies, the mortality rate didn't change significantly. The study highlights the value of early interventions but underscores the inherent severity of such injuries. References: Pang D, Hildebrand D, Bachoo P. Thoracic endovascular repair (TEVAR) versus open surgery for blunt traumatic thoracic aortic injury. Cochrane Database of Systematic Reviews 2019, Issue 2. Art. No.: CD006642. Jean JB, Konrad S, Ahmed K, et al. A systematic review of nonoperative management in blunt thoracic aortic injury. J Vasc Surg 2019;70:1675-81 W. Anthony L, Jon SM, R. Scott M, et al. Endovascular repair of traumatic thoracic aortic injury: Clinical practice guidelines of the Society for Vascular Surgery. J Vasc Surg 2011;53:187-92 No

Poster

Prof. Dr.

Why proper technique matters: Intrahepatic chest tube placement

Case history: We present the case of a 44-year-old patient, admitted to the Intensive Medicine Unit of another institution due to severe alcoholic acute pancreatitis with organ failure. Due to right pleural effusion the patient underwent placement of a chest tube, with only an initial amount of hematic fluid being recovered. The pleural effusion persisted and imaging control confirmed its intrahepatic placement. At this stage, the patient is transferred to our center. Clinical findings: Persistent pleural effusion Results: Thoraco-abdominal CT confirmed that the drain had a descending path, transversing the right hemiliver (segments 6 and 7), with the extremity immediately lateral to the retrohepatic inferior vena cava. We opted for conservative management, with stepwise mobilization of the drain, (3 centimeters a day) and follow-up imaging. After 4 days the drain was removed with no bleeding or biliary fistula and no need for surgical intervention or angioembolization. Diagnosis: Intrahepatic drain Therapy and Progressions: We opted for conservative management, with stepwise mobilization of the drain, (3 centimeters a day) and follow-up imaging. After 4 days the drain was removed with no bleeding or biliary fistula and no need for surgical intervention or angioembolization. Comments: Immediate hematic drainage in a supposedly serous pleural effusion and hemodynamic instability after chest tube placement on the right, should raise the suspicion of liver injury. The most severe consequence is uncontrolled bleeding, which may require operative management or angioembolization. In the case we report the drain was safely removed from inside the liver parenchyma without need for further intervention. This complication, rarely described in the literature, is avoidable with the use of proper technique. References: 1.Collop NA, Kim S, Sahn SA. Analysis of tube thoracostomy performed by pulmonologists at a teaching hospital. Chest 1997;112:709–13.No

Partial gallbladder avulsion due to blunt abdominal trauma – A case report

Emergency surgery

Case history: We present the case of a 21-year-old man, who was involved in a motorcycle accident, resulting in blunt abdominal trauma. He presented to our hospital's emergency department 48 hours after the accident with abdominal pain. Clinical findings: On physical examination, he was hemodynamically stable but had diffuse abdominal tenderness, particularly in the epigastrium and right hypochondrium. Investigation/Results: A CT scan revealed a thickened and bilobed gallbladder without stones, characterized by the radiologist as possible cholecystitis, with no other thoraco-abdomino-pelvic findings. Diagnosis: Due to persistent abdominal pain with tenderness on palpation, surgical intervention was proposed. Intraoperatively, a small volume of hemoperitoneum was observed, along with partial avulsion of the gallbladder and a laceration in hepatic segment IV. Therapy and Progressions: Cholecystectomy was performed. The patient was discharged on the 11th postoperative day. Comments: Traumatic injuries of the gallbladder are unusual and can go unnoticed due to nonspecific clinical findings. A high degree of suspicion and early imaging studies are recommended to avoid delayed diagnosis. The rarity of this injury and the diagnostic challenge in the preoperative period justify the interest in publishing this case. The treatment implemented, according to the current literature, was appropriate. References: Khan, M. R., &amp; Begum, S. (2020). Isolated gallbladder injury from blunt abdominal trauma: A rare co-incidence. JPMA.The Journal of the Pakistan Medical Association, 70(Suppl 1)(2), S95–S98. https://pubmed.ncbi.nlm.nih.gov/31981345/;Abouelazayem, M., Belchita, R., &amp; Tsironis, D. (2021).Isolated Gallbladder Injury Secondary to Blunt Abdominal Trauma. Cureus.https://doi.org/10.7759/cureus.15337 Fig.1: Hepatic laceration and gallbladder with a hemorrhagic appearance Fig.2: Gallbladder with partial avulsion from the hepatic bedNo

Bile duct injury after blunt abdominal trauma – An infrequent consequence of a common problem

Polytrauma

CASE HISTORY: We present a case of a 54-year-old man who was admitted to the emergency room of a central hospital after a motor vehicle crash. CLINICAL FINDINGS: He was hemodynamically stable with a GCS of 15 at initial assessment. After primary and secondary survey it was found a small subarachnoid haemorrhage, extensive pulmonary contusion, a grade II hepatic laceration, grade I splenic laceration, retroperitoneal hematoma without active haemorrhage and an acetabular fracture. He was admitted to the ICU for surveillance. On follow-up there were some complications with progressive deterioration. 30 days after admission he developed a septic shock due to an intra-abdominal abscess. INVESTIGATION: An exploratory laparotomy was performed due to suspicion of bowel perforation, not confirmed. The only finding was an infected extensive retroperitoneal haematoma that was debrided and drained. In the first postoperative day high output biliary content was found in the abdominal drain. DIAGNOSIS: The diagnosis of a bile leak in the distal portion of the common bile duct was later confirmed by endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and bile duct stenting. THERAPY: The ERCP associated with percutaneous drainage of abdominal collections allowed progressive resolution of the bile leak. COMMENTS: Bile duct injuries associated with trauma are infrequent, mainly in the context of blunt trauma. The incidence reported is 3-5%. They are usually associated with other major lesions, mostly hepatic. The diagnosis is typically delayed, as in our case, which can predispose to the development of potentially serious complications. A high index of suspicion is necessary for the early diagnosis as findings may be subtle.1,2 REFERENCES: Balzarotti et al. Isolated extrahepatic bile duct rupture: a rare consequence of blunt abdominal trauma, WJ of Emergency Surgery 2012 Park et al. Isolated Common Hepatic Duct Injury after Blunt Abdominal Trauma, J Trauma Inj 2017 No

Prophylactic splenic angioembolization avoids unnecessary splenectomies due to trauma

INTRODUCTION: The spleen is one of the most frequently damaged organs in trauma. Some studies support splenic angioembolization (SA) in haemodynamically stable patients with splenic trauma (ST) in order to avoid splenectomy. In HGU Gregorio Marañón, a prophylactic SA protocol was started in December 2017 in stable patients with AAST grade IV and V ST. OBJECTIVES: The aim of this study is to analyse adherence to the protocol and whether the rate of splenectomies has decreased after its implementation. MATERIALS AND METHODS: Retrospective cohort study of all ST patients in our centre in two periods: 2013-2017 and 2018-2023 (protocol period). We analysed demographic data, mechanism of injury, grade of ST according to AAST, performance of SA and splenectomy, complications associated with both techniques, mortality and, in the period 2018-2023, adherence to the protocol. Data analysis was performed using IBM SPSS Statistics v. 23. RESULTS: Between 2013 and 2017 there were 56 ST, 23% gr IV and 5.5% gr V. 9 therapeutic SA were performed: 2 in ST gr III and 7 in ST gr IV (5 clinical success); there were no complications. 16 splenectomies were performed: 1 in gr II ST after conservative management failure, 6 in gr III ST (2 after SA failure), 6 in gr IV ST (2 after SA failure) and 3 in gr V; 3 patients had complications. There were 3 deaths, none related to ST. Between 2018 and 2023 there were 54 ST, 20.4% gr IV and 18.5% gr V. 7 prophylactic SA were performed, all gr IV, within 24 hours of admission; there were no complications. 11 splenectomies were performed: 9 in gr V (1 stable), 1 in gr IV stable (arteriography was performed but no SA) and 2 in gr III; 3 patients had complications. There were 6 deaths, none related to ST. CONCLUSION: Prophylactic SA in ST has reduced the rate of splenectomy in grade IV-V ST in one third of patients, avoiding potential postoperative complications, without complications associated with SA. Adherence to the protocol was 88.9%.No

Treatment strategies for splenic trauma: A comprehensive analysis in an portuguese hospital

Introduction: Splenic trauma injuries are a significant concern in trauma surgery. Traditionally managed surgically, recent years have shifted towards non-operative management (NOM), aiming to preserve the spleen and reduce long-term complications. Splenic trauma encompasses a range of injuries, necessitating meticulous assessment and a strategy based on anatomy, hemodynamics, and other injuries. This study aims to review the treatment strategies for splenic trauma in a Hospital with ACS level II trauma resources. Material &amp; Methods: Retrospective analysis of adult patients admitted to the Surgical Department of our centre with traumatic spleen injuries between January 2013 and September 2023.Results: 23 patients were admitted for splenic trauma, of whom 12 had additional trauma sites. All patients had blunt trauma. 30% of the patients had minor splenic injuries (WSES class. I: 7), 22% had moderate injuries (WSES class. II: 3; WSES class. III: 2), and 48% had severe injuries (WSES class. IV: 11). All minor traumas were treated with NOM, and the rest of the patients were treated with splenectomy, except 1 patient who was offered a splenic conservative surgery, later converted to splenectomy after rebleeding. Among the NOM group, 1 death was reported after 50 days of admission, not related to trauma, and among the splenectomized patients, 5 deaths were reported. Conclusions: The NOM was mainly offered to minor spleen injuries, with successful results. In contrast, moderate and severe injuries received surgical treatment, which may suggest the need to implement a protocol for improving the NOM among moderate injuries. References: Coccolini, F. et al. Splenic trauma: WSES classification and guidelines for adult and pediatric patients. World J Emerg Surg 12, 40 (2017). DOI: 10.1186/s13017-017-0151-4; Perrotta G. et al. Splenic trauma: Definition, classifications, clinical profiles and best treatments. Open J Trauma 5(1): 019-036 (2021). DOI: 10.17352/ojt.000038 No

Spleen autotransplantation on liver: A spleen preserving method for simultaneous traumatic liver and spleen injuries-an experimental investigation

Introduction. Intra-omental splenic autotransplantation is a method for preserving spleen function after splenectomy, but it is associated with some postoperative complications. The present study aimed to compare the effectiveness of implanting splenic fragments in omentum with hepatorrhaphy and splenic autotransplantation in the form of a patch on the liver tissue in a simulated simultaneous spleen and liver trauma requiring splenectomy and hepatorrhaphy. Material &amp; Methods. Twenty-four rats were divided into omental transplant (OT) or liver patch (LP) groups. An identical simultaneous full thickness liver (left lobe) and grade four-spleen injury was performed on all rats. We measured the levels of hemoglobulin (Hb), white blood cell (WBC), complement levels (C3, C4), and immunoglobulin G, M, and A (IgG, IgM, IgA) before and four weeks after the surgery. Also, Technetium-99m scintigraphy was performed to assess the postoperative splenic function. Results. There was no significant difference between the groups" preoperative hematological factors. Surgery significantly reduced Hb, C3, IgG and IgA in both groups (p&lt;0.05). WBC counts were significantly increased, while IgM level was significantly decreased after intervention in the OT group. The mean difference of WBC, IgM, and IgA were significantly different between the two groups. For WBC, it was in favor of the OT group while for IgM and IgA it was in favor of LP group. The mean difference of other variables were not statistically significant. The radioisotope uptake was similar between groups after surgery (p=0.3). Conclusion. In dual injuries of spleen and liver, implanting splenic tissues on the liver parenchyma instead of spleen auto-transplant in the omentum seems to be an effective surgical method for preserving the function of the spleen, but the evaluation of its safety needs more clinical study on human. Figure 1. Comparison of pre and postoperative hematologic and immunologic variables in each groupNo.

Outcomes of gelfoam versus non-gelfoam materials in spleen injury embolization: A retrospective study

Introduction: Nonoperative management (NOM), especially transcatheter arterial embolization (TAE), is central to managing spleen injuries. TAE uses various hemostatic materials, including temporary ones like gelfoam and permanent options such as coils and glue. Studies indicate potential differences in infection and rebleeding rates between these materials. Objectives: This study investigates infection and rebleeding rates post-spleen angioembolization with different hemostatic materials. Patients &amp; Methods: A retrospective review was conducted on 252 spleen injury patients admitted from 2016 to 2021. Results: Patients averaged 44.5 years; 191 were male, 61 female. AIS scores distribution: AIS 1 (30), AIS 2 (93), AIS 3 (50), AIS 4 (53), AIS 5 (25). Treatments varied: 107 observed without TAE/surgery, 18 underwent diagnostic angiograms, 83 received TAE (7 excluded post-transfer), 31 had splenectomy, and 13 had splenorrhaphy/hemostasis. In TAE, gelfoam, coils, glue, and polyvinyl ethanol were used: 46 with one, 27 with two, and 3 with three materials. Comparing gelfoam with non-gelfoam groups, no significant differences in age (22.9 vs. 24.5) or gender ratio (79.6% vs. 70.4%) were noted. Rebleeding/surgery rates were higher in the gelfoam group (64.3% vs. 35.7%; p=0.6), as were deep SSI (2% vs. 0%) and sepsis (20% vs. 11%; p=0.58), though not statistically significant. Conclusion: No significant differences were found between gelfoam and other materials in TAE, but a trend toward higher infection and re-intervention rates with gelfoam was noted. These preliminary findings suggest further, more extensive research is required for conclusive insights on the impact of embolization materials on spleen injury treatment outcomes.No

Prophylaxis for venous thromboembolism in patients with blunt Solid Organ Injury (SOI) – An institutional experience

Introduction Initiation of chemothromboprophylaxis following blunt solid organ trauma is often a difficult decision for the treating clinician, having to balance the risk of bleeding versus the risk of clots. The American Association for the Surgery in Trauma recommends initiation within 48 hours of injury without ongoing concerns about bleeding. We have looked at our institution's practice over four years and performed a snapshot survey of our consultant GI surgeons. Material &amp; Methods Retrospective chart review from Jan 2018 to Dec 2022 of patients coded with abdominal trauma, identifying the grade of injury, date of injury, date of initiation of thromboprophylaxis, adverse events and incidence of VTE within 30 days—a snapshot survey of all of the GI surgical consultants at our institute regarding their usual practice. Results Over four years, 176 patients were identified, 67 adults with blunt solid organ trauma without immediate operative intervention. (see table 1). 38/67 (57%) were not given chemoprophylaxis during admission (median LOS 5 days), including five patients who underwent angioembolisation on days 0-1. 8/67 were given chemoprophylaxis within 48 hours, with no rebleeds, 3/67 at 72 hours, and 5/67 at five days. There were no rebloods, and the incidence of VTE at 30 days was zero. Snapshot survey: 47% would routinely hold off prophylaxis, 5% would commence at 24 hours, 21% would commence at 48 hours, 15% after reimaging, and 10% would do something else. (Fig 1) Conclusions At our institution, the department's practice and intention to treat are variable. There is no set local guidance about recommended practice. We have not had an incidence of documented VTE within 30 days, but given trauma is a pro-coagulant pathology and the management of some solid organ injuries includes bedrest, thinking about early prophylaxis is essential. References Rappold JF, Sheppard FR, Carmichael II SP, et al. Trauma Surg Acute Care Open 2021;6:e000643.No

Giant splenic pseudocyst 3 months after a blunt abdominal trauma – Case study

We present a 40-year-old male patient observed in the Emergency Department for left abdominal pain with a 2-month evolution with increasing pain and weight loss. No relevant history, except a fall at home 3 months prior, with no observation in a medical facility. The physical examination revealed a pale skin tone and an asymetric abdomen, painful to palpation in the left quadrants. The patient was hemodynamically stable. The labs revealed a normochromic normocytic anemia and an elevation of inflammatory markers. The CT-scan reported a subcapsular splenic collection, with approximately 29.5x28x22.8 cm, exerting a mass effect and displacing adjacent structures. Considering its size and symptoms, it was decided to perform an open splenectomy. Intra-operatively, we stated a mass extending from the xiphoid appendix to the pelvic cavity. To safely isolate the mass, it was necessary to drain the fluid inside, around 10 liters of a yellow-white fluid with a thick consistency. No complications during the procedure. The microbiological examination revealed sterile conditions and amylase analysis was not possible to perform. Histopathological examination confirmed the diagnosis. The patient was discharged after 4 days and had prophylactic vaccination two weeks after surgery. Splenic pseudocyst is a rare condition, mostly post-traumatic (75%) and resulting from the failure of complete reabsorption of a subcapsular or intra-parenchymatous hematoma, by its liquefaction and encapsulation. Mostly are asymptomatic but can produce symptoms by displacing or compressing adjacent intra-abdominal organs, as in this case. Despite the optimal treatment remains to be defined, due to vulnerability for hemorrhage, rupture, and infection, when &gt;5 cm or symptomatic, surgery treatment is recommended. This case highlights that, in addition to the acute setting, surgeons must be aware of the delayed complications of blunt abdominal trauma.No

Case report – Staged surgical management of pancreatic trauma in a 29-year-old patient after bull strike

Introduction Pancreatic trauma is a rare but potentially life-threatening injury that can occur in the context of blunt or penetrating abdominal trauma. Managing such cases requires a tailored approach, considering the extent of the injury and the patient&quot;s clinical condition. Patient &amp; Methods A 29-year-old male was admitted to the emergency department following a bull strike in a local bull run event. On arrival he was hemodynamically stable, with epigastric tenderness but no signs of an acute abdomen. His blood work showed an elevated amylase value. A CT scan was ordered which showed a pancreatic lesion classified as grade IV (AAST), with total disruption of the pancreatic main duct, as well as a hemoperitoneum and a large retroperitoneal hematoma. He also presented with a fractured C3 vertebrae and a pulmonary contusion. The patient was then admitted to the ICU for monitoring and had surgery the day after the trauma. In this procedure a transcystic cholangiogram was performed along with resection of the pancreatic head, without reconstruction, allowing for improvement of local and systemic inflammation. Four days later the Whipple procedure was completed, with standard pancreatic, biliary and gastric anastomosis. Results In the post operative period the patient developed respiratory failure which required mechanical ventilation for two days. He also presented with a type B pancreatic fistula, which was managed with antibiotics. He was discharged at post operative day 31 and has remained clinically stable since. Conclusion Pancreatic trauma can result from diverse mechanisms and present a unique set of challenges in diagnosis and management. A staged surgical approach can be an effective strategy for managing complex pancreatic injuries while preserving as much viable tissue as possible. Close postoperative monitoring and supportive care are essential.No

Blunt abdominal trauma with three spot jejunal perforation – A case report

Case history: A 71-year-old male was brought to the emergency room following abdominal blunt trauma resulting from a collision between a car and the patient. Clinical findings: The patient was hemodynamically stable, but had an ecchymosis in the lower abdominal quadrants, tenderness, and guarding. No thoracic lesions were detected. He had a lactate level of 4.1, and hemoglobin of 14.3g/dL. Investigation/Results: He was started on fluids and underwent a thoraco-abdomino-pelvic CT scan, which revealed the presence of inter-loop free fluid and thickening in a segment of the small intestine. Diagnosis: Blunt abdominal trauma Therapy, Progressions: The surgical team performed an emergent exploratory laparoscopy, finding free enteric fluid in the lower quadrants. For a thorough exploration and treatment, they opted to convert to laparotomy. Intraoperative findings revealed free enteric fluid and three grade II jejunal loop perforations (according to the American Association for Surgery of Trauma (AAST) classification) within a 30cm segment. This led to a segmental enterectomy with a latero-lateral anastomosis. Postoperative recovery was uneventful, and the patient was discharged on the 10th day. Comments: This highlights the need for a thorough clinical history, comprehensive physical examination, and meticulous injury assessment. Surgeons must maintain a heightened level of suspicion for hollow viscus injuries in trauma patients, as delays in diagnosis and surgery may increase mortality risk. Here, a segmental enterectomy was chosen over primary repair, due to the presence of three separate perforations within the affected segment. References Smyth, L., Bendinelli, C., Lee, N. et al. WSES guidelines on blunt and penetrating bowel injury: diagnosis, investigations, and treatment. World J Emerg Surg 17, 13 (2022) Hacking C, Jones J, Bell D, et al. AAST injury scoring scales. Reference article, Radiopaedia.org (Accessed on 22 Oct 2023)No conflict of interest to declare

Associations between hollow viscus injury and acute kidney injury in blunt abdominal trauma: A national trauma data bank analysis

Background- Hollow organ perforation can lead to peritonitis and subsequent acute kidney injury (AKI), yet the relationship between traumatic hollow viscus injury (HVI) and AKI is not well understood. Utilizing data from the National Trauma Data Bank, we investigated whether HVI serves as a risk factor for AKI. Additionally, we examined the characteristics of AKI in stable patients who underwent conservative treatment. Methods- We reviewed blunt abdominal trauma (BAT) cases from 2012-2015, comparing patients with and without AKI. Significant factors from univariate analysis were tested in a multivariate logistic regression (MLR) to identify independent AKI determinants. We also analyzed subsets: patients without HVI and stable patients given conservative management. Results- Out of the 563,040 BAT patients analyzed, 9,073 (1.6%) developed AKI. AKI patients experienced significantly worse outcomes, with a higher mortality rate of 28.5% compared to 4.7% (p&lt;0.001), and an extended hospital length of stay (31.2 days vs. 9.7 days, p&lt;0.001). While a greater proportion of AKI patients had HVI than those without AKI (13.3% vs. 5.2%, p&lt;0.001), this difference wasn't statistically significant in the MLR (p=0.076). Notably, the need for laparotomy (odds=1.971, p&lt;0.001) and sepsis (odds=13.928, p&lt;0.001) were identified as independent risk factors for AKI. For BAT patients managed conservatively (SPB &gt; 90 mmHg, without HVI or laparotomy; N=497,066), the presence of sepsis was a significant predictor for the development of AKI (odds=17.594, p&lt;0.001). Conclusion- Our study revealed that while HVI wasn't a significant risk factor for AKI in BAT patients, the need for laparotomy was. Importantly, stable BAT patients managed conservatively are still at risk for AKI due to non-peritonitis related sepsis. Figure legends Figure 1. Study population and protocol of the current study. Figure 2. Comparisons of length of stay between BAT patients with and without AKINo

Injury patterns and patient outcomes of abdominal trauma in the elderly population in a major trauma centre: A 5-year experience

Introduction: The management of abdominal trauma in elderly patients could be challenging due to the coexisting comorbidities and diagnostic pitfalls. Age ≥ 65 years is an independent risk factor for increased mortality, compared to the same Injury Severity Score(ISS). Objectives: A retrospective observational study was conducted to describe the clinical practice and the epidemiological profile of elderly patients with abdominal traumatic injuries at University Hospital Southampton(UHS), a Major Trauma Centre(MTC) in the United Kingdom. Patients &amp; Methods: The inclusion criteria were trauma patients aged ≥ 65 years old and with Abbreviated Injury Scale (AIS) ≥ 1 for the Abdomen during the period January 2017-December 2022. Data was collected from the Trauma Audit and Research Network (TARN). Patients aged &lt; 65 years old or who were not alive on arrival to MTC were excluded. Results: Overall, 4977 trauma patients ≥ 65 years old presented during the 5-year study period. There were 150 eligible patients (3%) with abdominal injuries scoring AIS ≥ 1. Ninety-five(63%) were male with a mean age of 77 years.The spleen and liver were the most injured organs. The incidence of severe abdominal injuries (AIS ≥ 3) was 55 (37%) with 34 cases(22%) requiring surgical or radiological intervention. Only four patients sustained occult abdominal injuries and two of them had a negative CT scan on arrival. The overall 30-day mortality rate was 20%. Conclusion: The incidence of abdominal trauma in the elderly was 3% over 5 years, mainly secondary to falls. One-time imaging may not be sufficient to exclude occult abdominal injuries and careful monitoring is essential. The majority of abdominal injuries were managed non-operatively, nevertheless a high index of suspicion of visceral injury needs to be considered in this population to ensure optimal trauma care. The outcomes are reflective of the polytrauma nature and the coexisting comorbidities, not of the abdominal pathology alone. I have nothing to declare.

Poster session 15
Visceral trauma 2

Appointment

Chairs

Topic

Programme

Poster session 15Visceral trauma 2

Appointment

Chairs

Topic

Programme

Poster session 15
Visceral trauma 2