Global Journal of Medical Research, F: Diseases, Volume 22 Issue 1

The degree of damage to the parenchymal organs of the abdomen according to AIS III. R esults and D iscussion In the diagnosis of combined abdominal injuries, ultrasound played an important role. Instrumental studies were started with ultrasound, with further re-examination 1 hour after admission and every 3 hours during the day. Among 118 children with concomitant injuries, in 90 (76.3%) cases, an ultrasound examination of the abdominal organs was performed, in 5 (4.2%) cases an emergency operation was performed without preliminary ultrasound examination, 23 (19.5%) died during shock measures upon admission before the ultrasound. At the same time, the sensitivity of ultrasound in determining hemoperitoneum in patients with abdominal trauma was 95.6%, and the diagnostic efficiency was 97.9%. Polypositional radiography was performed according to standard techniques, while in 99 (83.9%) cases a simultaneous plain radiography of the skull, spine, chest and abdomen (including laterography), pelvis and extremities (according to indications) was performed. Of the total number of studies, 54 (53.5%) patients showed various bone-traumatic injuries of the limb on X-ray examination, 6 (5.94%) patients showed rib fractures and 39 (39.4%) children showed no pathology on X-ray. revealed. The sensitivity of X-ray examination in the diagnosis of injuries to the abdominal organs was low and amounted to 41.2 to 66.4%. Multispiral computed tomography (MSCT) is a non-invasive method that provides valuable additional information about the extent, number and extent of damage in associated injuries. MSCT was performed in 46 (39%) patients. At the same time, MSCT of the head and neck was performed in 11 (24%), chest - 4 (8.7%), abdomen - 12 (26%), pelvis - 2 (4.3%). In 3 (6.5%) cases, a total MSCT examination was performed from the head to the lower extremities, which made it possible to simultaneously reveal the presence of damage to all anatomical regions in a few minutes. MSCT had a sensitivity of 97% -98%, a specificity and accuracy of 98%. The final method in diagnosing abdominal injuries was laparoscopy, which made it possible to avoid unnecessary laparotomies. Diagnostic laparoscopy was performed in 45 (38.1%) cases of patients with ultrasound examination of the presence of free fluid in the abdominal cavity. Of these, 6 (5.1%) cases of abdominal injuries were not detected, in 4 (3.4%) patients, the operation was completed laparoscopically by coagulation of small ruptures of parenchymal organs and sanitation of the abdominal cavity: in 1 (0.8%) case performed laparoscopic suturing of the rupture of the liver, in 3 (2.5%)- diathermocoagulation of ruptures of the spleen. Diagnostic laparoscopy in 35 (29.7%) children revealed the presence of a large amount of blood due to deep damage to the liver and spleen with active bleeding, in connection with which they underwent a conversion to laparotomy. In 30 (25.4%) cases, laparotomy was immediately performed due to a large amount of free fluid on ultrasound and unstable hemodynamic parameters, among which in 23 (19.5%) cases the operation ended with coagulation and suturing of liver damage, in 32 (27 , 1%) - splenectomy. Diagnostic laparoscopy makes it possible to determine the amount and nature of fluid in the abdominal cavity and, based on this, the volume of the operation is planned: to complete the operation 5,1% n2 7,7% n3 35,9% n14 51,3% n20 SPLEEN 1 art 2 art 3 art 4 art [ЗНАЧЕН ИЕ] n8 [ЗНАЧЕН ИЕ] n12 [ЗНАЧЕН ИЕ] n14 [ЗНАЧЕН ИЕ] n6 LIVER 1 art 2 art 3 art 4 art 16 Year 2022 Global Journal of Medical Research Volume XXII Issue I Version I ( DD ) F © 2022 Global Journals Problems of Early Diagnosis of the Abdominal Cavity with Concomitant Abdominal Trauma in Children

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