MANAGEMENT OF BALLISTIC TRAUMA TO THE PELVIS AND BLADDER IN THE COMBAT PATIENTS INJURED IN RUSSO-UKRAINIAN WAR andrii.dinets@gmail.com

PE100

MANAGEMENT OF BALLISTIC TRAUMA TO THE PELVIS AND BLADDER IN THE COMBAT PATIENTS INJURED IN RUSSO-UKRAINIAN WAR

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Ukraine

Oral or Poster

The Russo-Ukrainian war is associated with application of all possible kinds of weapon, resulting in severe injuries, genitourinary trauma.The aim of the study to estimate and evaluate clinical features and approach for the management of ballistic injuries to the bladder in combat patients.

A 25 male patients with mean age of 38.1 years were injured with ballistic projectiles to the pelvis in the battlefield area in Ukraine. The management was performed in Role 4 hospital in Kyiv.

20 (80%) patients were diagnosed with combined injury to the pelvis and abdomen, 5 (40%) patients had pelvic injury only. 12 (60%) patients had gunshot injuries, 8 (40%) patients injured due to land-mine explosions, 5 (20%) patients had bladder rupture due to blunt trauma (fallings, and car accident due to FPV-drones attacks). The management of all cases included damage control surgery and damage control resuscitation. Minimally invasive surgery was applied in 11 (44%) patients considering clinical indications. Upon admission to Role 4 hospital, 15 (60%) of patients had peritonitis and treated with epicystostomy followed by postponed reconstruction surgery after stabilization, whereas in 10 (40%) patients were treated by suturing of the bladder defect. The bladder was preserved and normal urination was restored in 3-6 months after the injury.

Bladder ballistic injuries are common and severe in combat patients injured in ongoing war in Ukraine. The management of genitourinary trauma is with applications of damage control surgery and damage control resuscitation of both open and minimally invasive surgery.