Hematology is the branch of medicine that is involved in the study of the blood, and the organs that distribute the blood. The study also includes the diseases of blood.
Procalcitonin (PCT) is a part of the blood that affects the levels of calcium in the body. The levels of PCT in the blood are a useful way of monitoring the onset of various diseases such as pneumonia and sepsis.
The platelet distribution width (PDW) is a useful indicator as to whether somebody has certain diseases such as thromboembolic diseases. The PDW is measured and the higher the width, the more likely that these diseases are present.
The mean platelet volume (MPV) is a measurement of the average size of the ...view middle of the document...
This 22-year-old woman sustained a gunshot wound to the left flank. At exploration, she had a through-and-through laceration of her spleen. The bleeding was arrested by finger compression of the splenic hilum while it was mobilized. A splenectomy was performed because the bullet went through the hilum.
The severity of shotgun wounds depends on the distance of the victim from the weapon. The mass of a shot pellet is minimal, and thus its velocity decreases rapidly after the shell leaves the barrel of the gun. When the distance is less than 3 yd, the injury is considered high velocity; if the distance exceeds 7 yd, most of the buckshot penetrates only the subcutaneous tissue.
Stab wounds are caused by penetration of the abdominal wall by a sharp object. This type of wound generally has a more predictable pattern of organ injury. However, occult injuries can be overlooked, resulting in devastating complications.
In penetrating abdominal trauma due to stab wounds, the most commonly injured organs are as follows :
* Liver (40%)
* Small bowel (30%)
* Diaphragm (20%)
* Colon (15%)
A stab wound is shown in the image below.
The patient's small intestine clearly protrudes through his anterior abdominal wall following a stab wound caused by a machete. The operative repair and recovery were uneventful.
The mechanism that underlies the penetrating trauma (eg, gunshot wound, stab wound, impalement) relates to the mode of injury (eg, accidental or intentional injury, homicide, suicide). Homicide or intentional injury is the predominant mode of abdominal injury in this patient population. Accidental injury is most common in pediatric home firearm injuries but is uncommon by comparison to the overall levels of homicide and intentional injury. Suicide via penetrating abdominal trauma is uncommon.
Etiology: Gunshot wounds, considered high-velocity projectiles, are the most common cause (64%) of penetrating abdominal trauma, followed by stab wounds (31%) and shotgun wounds (5%).
Penetrating abdominal trauma may result from urban violence. Domestic violence crosses all socioeconomic barriers and is an important consideration in the evaluation of injuries sustained at home and those reportedly involving the patient's family or significant other.
From a global perspective, penetrating abdominal trauma in most settings results principally from military actions and wars.
Penetrating abdominal trauma may be iatrogenically introduced. A documented complication of diagnostic peritoneal lavage is injury to the underlying bowel, bladder, or major vessels such as the aorta or vena cava. However, the incidence of such complications is relatively small.
Sexual and age-related differences in incidence
Males constitute the great majority of patients with penetrating trauma injuries across the United States and the world. In some areas of the United States, approximately 90% of patients with penetrating trauma are male. Injuries are the...