SURGICAL CARE FOR INJURIES TO THE PELVIC AND INTRAPARATIC ORGANS

Summary. The goal. In 2/3 of victims with closed abdominal trau­ma, there are injuries to internal organs and the skeleton with the development of retroperitoneal hematoma and bleeding. The mortality rate in victims with injuries to retroperitoneal structures and pelvic organs reaches 60%. The presence of blood loss raises the question for surgeons and traumatologists of the need to provide emergency surgical care, the purpose of which is to stop bleeding and eliminate its consequences after injury. Materials and methods. 114 victims (aged 19-70 years and older) with traumatic injuries of the pelvic organs and retroperitoneal space, accompanied by massive blood loss, who were treated in the traumatology department and the polytrauma department of the Kharkiv City Emergency Hospital named after Prof. O. I. Meshchaninov, as well as in the department of emergency surgery, traumatic shock, anesthesiology, resuscitation and intensive therapy of the State Institution «V. T. Zaitsev Institute of Internal Medicine of the National Academy of Sciences of Ukraine» were examined. The results. Urgent examinations were performed on all victims. Radiological methods were used. Thus, with the help of a survey radiograph of the abdominal cavity, not only fractures of the pelvic bones were detected, but also the presence of free gas in the abdominal cavity and accumulation of gas in the retroperitoneal space, signs of retroperitoneal hematoma, deformation of the urinary bladder by retroperitoneal hematoma. Ultrasound helped to establish the presence of a massive retroperitoneal and paranephral hematoma. Conclusions. The use of the balloon hemostasis technique to tem­porarily stop bleeding allows you to reduce the rate of blood loss, the growth of retroperitoneal hematoma, and prevent the development of purulent-septic complications, as well as improve the conditions for further assistance and the sequence of its implementation, depending on the extent of the injury.