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Blast: Mechanisms of Injury and Implications upon Treatment

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Textbook of Emergency General Surgery

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Abstract

Blast has the potential to create injury through several mechanisms, each with its peculiarities. Blast lung injury, tympanic membrane perforation, and blast intestinal injuries are the injuries most commonly associated with overpressures created by the blast. Yet, except tympanic membrane perforation, blast lung and intestinal injuries are not widely encountered. Instead, penetrating projectiles and displacement are the most common mechanisms leading to life-threatening injuries. Multiple body areas may be affected. Diagnosis of internal injuries is not straightforward since most low-energy projectiles are lodged in the subcutaneous tissues, and only a few penetrate deeply. The presence of distracting wounds further complicates the diagnosis of life-threatening injuries. Finally, multiple other injurious agents may be associated with the blast, such as burns, toxic material, and biological contaminants. Knowledge of the explosion-related mechanisms of injury is crucial for the proper diagnosis and treatment of casualties.

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Acknowledgment

The authors wish to thank Michael Alkan and Boris Isakovitch for their advice concerning different issues discussed in this chapter.

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  1. General Surgery Division, Rambam Medical Center, Haifa, Israel

    Itamar Ashkenazi & Yoram Kluger

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  1. Itamar Ashkenazi
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Correspondence to Yoram Kluger .

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  1. General, Emergency and Trauma Surgery Dept., Pisa University Hospital, Pisa, Italy

    Federico Coccolini

  2. General and Emergency Surgery Dept., Bufalini Hospital, Cesena, Italy

    Fausto Catena

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Ashkenazi, I., Kluger, Y. (2023). Blast: Mechanisms of Injury and Implications upon Treatment. In: Coccolini, F., Catena, F. (eds) Textbook of Emergency General Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-22599-4_28

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