Trauma abdominal - ATLS CASO CLINICO.pptx

trauma abdominal, control de daños posgrado de cirugia general

1. TRAUMA ABDOMINAL Y PÉLVICO Dra. Mayte Villegas R1 de Cirugía General y Laparoscópica Pontificia Universidad Católica del Ecuador

2. Introducción American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104]. Detección temprana de hemorragia oculta en abdomen y pelvis en traumas cerrados. Heridas entre la tetilla y el periné pueden causar lesiones intraabdominales. Factores clave: mecanismo de lesión, energía recibida, ubicación de la herida y estado hemodinámico. Lesiones no reconocidas son causa prevenible de muerte. Factores que dificultan la evaluación: intoxicación, trauma craneoencefálico, fracturas costales o pélvicas. La cavidad abdominal puede acumular sangre sin signos evidentes. Toda lesión abdominal o pélvica debe sospecharse hasta descartar daño visceral o vascular.

3. Anatomía del abdomen American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

4. Mecanismo de lesión American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

5. Trauma cerrado American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

6. American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

7. Trauma penetrante American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

8. Trauma por explosión American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

9. Evaluación y manejo American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

10. Historia American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

11. Inspección, Auscultación, Percusión y Palpación American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

12. Evaluación pélvica American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

13. American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

14. Examen Uretral, Perineal, Rectal, Vaginal, y de Glúteos American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

15. ANEXOS AL EXAMEN FÍSICO Después de diagnosticar y tratar los problemas de la vía aérea, la respiración y la circulación del paciente, se suelen insertar catéteres gástricos y urinarios como anexos a la valoración primaria. American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

16. Tubos Gástricos y Urinarios American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

17. American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

18. Radiografías para el Trauma Abdominal American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

19. Evaluación por Ecografía Focalizada en Trauma (FAST) American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

20. American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

21. Lavado Peritoneal Diagnóstico American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

22. American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

23. Tomografía Computarizada American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

24. American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

25. Laparoscopía Diagnóstica o Toracoscopía American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

26. EVALUACIÓN DE LESIONES PENETRANTES ESPECÍFICAS American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

27. INDICACIONES DE LAPAROTOMÍA American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

28. Otras lesiones Lesiones Diafragmáticas El desgarro del diafragma afecta principalmente el hemidiafragma izquierdo. La radiografía de tórax inicial puede mostrar: Elevación del hemidiafragma. Hemotórax o gas anormal. Tubo gástrico en el tórax. Diagnóstico confirmado por laparotomía, toracoscopía o laparoscopía. Lesiones Duodenales Comunes en conductores sin cinturón en colisiones frontales. Sospecha ante aspirado gástrico sanguinolento o aire retroperitoneal en radiografía/TAC. Indicaciones: estudio seriado gastrointestinal, TAC con doble contraste o laparotomía urgente. American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

29. American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

30. American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

31. Fracturas pélvicas y lesiones asociadas Mecanismos de lesión: Compresión AP (Accidente vehicular o motocicleta): Rotación externa de hemipelvis , separación de la sínfisis del pubis, y desgarro de plexo venoso posterior y arterias ilíacas internas. Hemorragia severa y potencialmente letal. Compresión lateral (Colisión vehicular): Hemipelvis gira internamente, reduciendo volumen pélvico. Daño posible a la vejiga/uretra. La hemorragia es menos letal pero puede causar morbilidad severa y requiere control de hemorragia ( angioembolización ) Cizallamiento vertical (Caída desde altura): Fuerza de alta energía en plano vertical, interrumpe vasculatura ilíaca. Hemorragia severa y gran inestabilidad pélvica. American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

32. Manejo Inicial del Shock Hipovolémico por Disrupción Pélvica Mayor American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

33. Manejo Avanzado y Consideraciones de Traslado American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

34. American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

35. American College of Surgeons. Advanced Trauma Life Support: Student Course Manual. 10th ed. Chicago: American College of Surgeons; 2018. Chapter 5, Abdominal and pelvic trauma; p. [84 - 104].

36. Muchas gracias