DISASTER MEDICINE No. 4•2022
Analysis of the Results of Treatment of Pelvic Injuries with Reproductive System Damage in Women in Conditions of Local Armed Conflict
Maslyakov V.V.1, Sidelnikov S.A.1, Dadaev A.Ya.2, Bukharova L.A.3, Parshin A.V.1, Kulikov A.V.1, Ivanova K.A.1
1 Saratov State Medical University named after V.I. Razumovskiy of the Ministry of Health of the Russian Federation, Saratov, Russian Federation
2 Chechen State University named after A.A. Kadyrov, Groznyy, Russian Federation
3 Private Institution Educational Organization of Higher Education “Medical University “Reaviz”, Saratov, Russian Federation
UDC 616-089. 616-001.45:618.17
Summary. The aim of the study was to analyze the results of treatment of pelvic gunshot wounds with damage to the reproductive system organs in women in a local armed conflict.
Materials and research methods. A retrospective analysis of the results of treatment of 86 patients with pelvic gunshot wounds with genital damages was performed. All the patients were members of the general population. Treatment was carried out at Grozny City Clinical Hospital in 1997-2005. The mean age of patients was (25±7) years. Female patients of fertile age with gunshot wounds in the pelvic area with damages of reproductive organs were included in the study. The following patients were excluded: patients younger than 18 and older than 45 years; patients with concomitant injuries of the chest, head, limbs, and patients in agonal state.
Study results and their analysis. The results of the study showed that most of the women had severe injuries, which resulted in bleeding, pain syndrome and shock as a consequence. Severe injuries were often combined with pelvic injuries and required wide laparotomy and revision of the abdominal cavity organs. The signs of peritonitis due to concomitant injuries at the moment of admission limited the choice of tactics.
In the nearest postoperative period the complications were related mainly to the purulent-inflammatory processes in 24.4% of cases. Nineteen patients died (22.1%). The main causes of lethal outcome were: shock in 15.1% of cases; purulent-septic complications in 6.9% of cases.
It has been concluded that severe gunshot wounds of the pelvic organs in women, accompanied by the reproductive system injuries, are characterized by a severe postoperative course, a great number of lethal outcomes and require urgent hospitalization in a multidisciplinary hospital.
Keywords: gunshot wounds, local armed conflict, reproductive system organs, small pelvis, women
For citation: Maslyakov V.V., Sidelnikov S.A., Dadaev A.Y., Bukharova L.A., Parshin A.V., Kulikov A.V., Ivanova K.A. Analysis of the Results of Treatment of Pelvic Injuries with Reproductive System Damage in Women in Conditions of Local Armed Conflict. Meditsina Katastrof = Disaster Medicine. 2022;4:34-38 (In Russ.). https://doi.org/10.33266/2070-1004-2022-4-34-38
- Bondarenko A.V., Kruglykhin I.V., Plotnikov I.A., et al. Features of Treatment of Pelvic Injuries in Polytrauma. Politravma = Polytrauma. 2014;3:46-62 (In Russ.).
- Salakhov Z.A. Modernization and Improvement of the System of Medical Evacuation Measures in Providing Qualified Surgical Care to the Wounded with Gunshot Wounds of the Pelvis and Pelvic Organs. Aktualnyye Problemy Gumanitarnykh i Yestestvennykh Nauk. 2009;10:322-327 (In Russ.).
- Corriere J.N., Sandler C.M. Diagnosis and Management of Bladder Injuries. Urol. Clin. North. Am. 2006;33:67-71.
- Shlamovitz G.Z., McCullough L. Blind Urethral Catheterization in Trauma Patient Suffering from Lower Urinary Tract Injuries. J. Trauma. 2007;62;2:330-335.
- Gomez R., Ceballos L., Coburn M., et al. Consensus Statement on Bladder Injuries. BJU Int. 2004;94;1:27-32.
- Gumanenko Ye.K., Boyarintsev V.V., Suprun T.Yu., et al. Obyektivnaya Otsenka Tyazhesti Travm = Objective Assessment of Injury Severity. St. Petersburg, VMedA Publ., 1999. 110 p. (In Russ.).
The material was received 11.08.22; the article after peer review procedure 22.09.22; the Editorial Board accepted the article for publication 23.12.22