RESUMEN
At St Vincent's Hospital, Melbourne, the number of patients admitted annually with road crash injuries has remained almost constant for the past 14 years. Comparing admissions in the seven years before and during the seven years since enactment of seat belt legislation in Victoria, there has been no change in the proportion of those admitted with abdominal injuries, in the number of associated non-abdominal severe injuries, or in the death rate of those admitted with abdominal injuries. There has, however, been a significant increase in the number of patients admitted with injuries of the gastrointestinal tract and diaphragm. It is suggested that this increase is due to incorrect wearing of the lap component of seat belts with resulting acute abdominal compression.
Asunto(s)
Traumatismos Abdominales/epidemiología , Accidentes de Tránsito , Cinturones de Seguridad/efectos adversos , Traumatismos Abdominales/etiología , Adulto , Australia , Diafragma/lesiones , Femenino , Humanos , Legislación como Asunto , Hígado/lesiones , Masculino , RoturaRESUMEN
In the five-year period 1972 to 1976 the author's preferred treatment for patients with chronic duodenal or prepyloric peptic ulcer requiring surgery was proximal gastric vagotomy. In spite of this preference, only two-thirds of such patients were so treated. Most patients with bleeding and stenosis were treated by bilateral truncal vagotomy and drainage, and a few by Pólya gastrectomy. Proximal gastric vagotomy proved to be a safe elective operation without mortality and with a proven ulcer recurrence rate so far of 6%. Compared with those who had bilateral truncal vagotomy and drainage, the proximal gastric vagotomy patients complained less often of diarrhoea but more often of weight loss and reflux. Two patients have had persistent postprandial non-peptic pain, thought possibly due to upper gastric ischaemia.