Procena uspeha konzervativnog lečenja zatvorenih povreda solidnih abdominalnih organa kod dece
ДокторандĐorđević, Ivona M.
Чланови комисијеSlavković, Anđelka
МетаподациПриказ свих података о дисертацији
Abdominal trauma is the cause of difficult injuries in children and the most common area of initially missed diagnosis, which often leads to a fatal outcome. Implementation of conservative (non-operative) treatment in all clinical and hemodynamically stable patients regardless of the severity of the violation is considered to be the best therapeutic concept The aim of the thesis was to analyze the effectiveness of nonoperative treatment in patients with documented isolated injury of solid abdominal organs and creates a uniquefollow up protocol for each organ to examine the incidence of complications and accompanied morphofunctional changes of injured organs. The methodological procedure is based on a comparative prospective study which analyzes the 46 patients under the age of 18 years treated from 1.1.2011. to 31.12.2014. year with the implementation of follow up protocol in posttraumatic period. The results clearly show that the success of nonoperative treatment is large, up to 93....75%, with a very low complication rate (6.25%) that require surgical treatment. It has been demonstrated that the hemodynamic and clinical stability are crucial parameter that determines the application of non-operative treatment regardless of the severity of the injury of solid of abdominal organs. In the period after trauma is necessary to do the clinical examination continuosly in order to follow morphofunctional changes and the possible complications. The results show that complications occur most often in the early period of time after the trauma more often in severe injuries of the pancreas and kidney. We conclude that in all hemodynamically stable patients should favor minimally invasive therapeutic approach-nonoperative treatment, which requires continuous monitoring and individual therapeutic approach that should be based on knowledge of basic physiological principles of functioning of the young patient.