Current Management of Gynecologic Trauma - 08/06/20
, Madelyn Hernandez a , Andrew Sparks a , Kyra Folkert a , Vincent Butano a , Gaby N. Moawad b , Jordan S. Klebanoff b, ⁎ , Babak Sarani a , Stephen Gondek c Bienvenue sur EM-consulte, la référence des professionnels de santé.
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Abstract |
Introduction |
To date, there are few reports describing the management of traumatic gynecologic injuries leaving physicians with little guidance.
Objective |
Describe the injury patterns and the preferred management of these injuries.
Methods |
A retrospective cohort study was performed using the National Trauma Data Bank (NTDB) from years 2011 to 2013. Female patients age 16 years and older with internal gynecologic injuries were identified based on diagnosis codes. Demographics, associated diagnoses and procedure codes were compiled for the cohort.
Results |
313 patients met inclusion criteria. The mechanism of injury was blunt in 236 (75%) patients, penetrating in 68 (21%), and other in 9 (4%). The mean Injury Severity Score was 16.6 ± 14.6. Mean age was 34 ± 21 years old. 226 (74.8%) patients had an ovarian and/or fallopian tube injury, 71 (25.2%) had a uterine injury, 8 (3%) had both, and 8 (3%) had injury to the ovarian or uterine vessels only. Of the 226 patients with ovarian and/or fallopian tube injury, 11(5%) underwent repair and 10 (4%) underwent salpingo-oophorectomy. Of the 71 uterine injuries, 15 (21%) underwent repair and 5 (7%) required a hysterectomy.
Conclusions |
Most traumatic internal gynecologic injuries result from blunt mechanism. Currently, these injuries are largely managed non-operatively. When surgery was performed, ovarian and uterine repair was more common than salpingo-oophorectomy and hysterectomy. Prospective large-scale studies are needed to establish a standard of treatment for the management of gynecologic trauma and to assess both short and long term outcomes and fertility rates.
Le texte complet de cet article est disponible en PDF.Keywords : Trauma, Gynecologic trauma, Pelvic trauma
Plan
Vol 49 - N° 6
Article 101731- juin 2020 Retour au numéro
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