Which one of the following statements related to gastric injury is untrue: (AIIMS May 2012)
|A||Mostly related to penetrating trauma|
|B||Treatment is simple debridement and suturing|
|C||Blood in stomach is always indicative to gastric injury|
|D||Heals well and fast|
a. The incidence of gastric injury with penetrating abdominal trauma is anywhere from 5% to 20% As mentioned previously, its location and mobility, as well as its size, place the stomach at risk from penetrating injury.
b. Blunt gastric injuries are fairly uncommon and have been reported in less than 1% of cases of blunt abdominal injury.
c. Clinical findings that may suggest gastric injury include hematemesis, aspiration of blood from a gastric tube, or pneumoperitoneum on plain films.
d. Water-soluble contrast studies of the upper GI tract can be used to detect gastric perforation, but their main use is for the diagnosis of gastric and duodenal hematoma.
e. DPL is generally used for the evaluation of a hemodynamically unstable blunt trauma victim with equivocal or negative FAST results.
f. Because of the stomach's large size and generous blood supply, most wounds are amenable to primary repair by either hand-sewn or stapling techniques.
g. Intramural hematomas are repaired with an interrupted Lembert suture technique after evacuation of the hematoma.
h. Small lacerations can be repaired in two layers after adequate débridement. The inner layer should be a full-thickness hemostatic absorbable suture and the outer layer, an interrupted seromuscular suture. Alternatively, a TA stapler can be used to resect the gastric laceration.
i. Repair of wounds near the GE junction or pylorus may result in stenosis. A pyloric wound might require conversion to a pyloroplasty. Some wounds may be extensive and necessitate either proximal or distal gastrectomy. If a vagus nerve injury is encountered, a drainage procedure should be performed