Emergency War Surgery NATO Handbook: Part IV: Regional Wounds and Injuries: Chapter
XXX: Reoperative Abdominal Surgery
Introduction
United States Department of Defense
Certain complications that arise after initial abdominal operation require abdominal
reoperation. As the casualty progresses rearward along the medical evacuation chain,
medical personnel must be ever vigilant in the early recognition of these complications.
The U.S. Air Force, with its aeromedical evacuation responsibility, has a special interest
and great experience in the recognition and treatment of these complications. During the
Vietnam conflict, one of every six casualties with abdominal wounds removed from the air
evacuation system at Clark Air Force Base required reoperation.
Because of the severity of their abdominal wounds and the high frequency of associated
injuries, these patients frequently present confusing findings. The indications for
reoperation. are often not well defined. To make matters even more difficult, these
complications may not develop until the postoperative patient arrives at a higher echelon
hospital and comes under the care of surgeons who were not involved in the primary
operation. On occasion, the medical records accompanying these patients may lack
sufficient detail regarding the injury and the details of the first operative procedure to
be helpful in subsequent evaluation. Given these circumstances, the surgeon must rely
heavily on past experience for guidelines in reoperation of abdominal war wounds. The
inherent problems of making a preoperative diagnosis in the most difficult group of
patients should not deter an aggressive approach. This philosophy will prove much more
rewarding than procrastination. Practical points gained from such experience follow.
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Operational Medicine 2001
Health Care in Military Settings
Bureau of Medicine and Surgery
Department of the Navy
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Washington, D.C
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Operational Medicine
Health Care in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMED P-5139
January 1, 2001 |
United States Special Operations Command
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MacDill AFB, Florida
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