Citation

Massalou D, Ichai C, Mariage D, Baqué P. J. Visc. Surg. 2019; 156(1): 17-22.

Affiliation

Chirurgie générale d'urgence, centre hospitalier universitaire de Nice, université Nice-Sophia-Antipolis, 30, voie Romaine, 06000 Nice, France.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.jviscsurg.2018.04.004

PMID

29716840

Abstract

INTRODUCTION: After the attacks in Paris, France was again struck by terrorism in the city of Nice during the night of July 14, 2016. At 22:33 in the evening, a 19-ton truck drove into the crowd of holiday celebrators. The attack resulted in 458 wounded and 86 deaths. The purpose of this study was to describe the management of patients with abdominal trauma admitted alive in our institution, in the context of a massive influx of victims. MATERIAL AND METHODS: We performed a retrospective analysis of the management of adults with abdominal trauma arising from the terrorist attack in Nice.

RESULTS: Among the 182 victims admitted to our trauma center, eleven patients presented with abdominal trauma. The median age was 44 years [14-63] and the median Injury Severity Score (ISS) was 34 [9-59]. Eight patients underwent urgent surgical treatment in the operating room including six for abdominal trauma. These patients were treated according to the principles of surgical damage control, albeit without the need for temporary abdominal closure or packing. Three patients could have had their lesions managed non-operatively had they been admitted outside this surge episode, which saturated the technical means of the receiving hospital.

CONCLUSION: The terrorist attack that victimized the citizens of Nice resulted in the second largest number of dead of any attack on French soil. A large number of patients were admitted to the city's only center for adult trauma care. The management of these patients posed diagnostic, therapeutic and logistical problems. Increased use of pre-hospital pelvic restraint belts may help to reduce vehicular trauma. We do not feel that non-operative management of abdominal lesions can be envisaged in the context of a mass influx of victims. We recommend surgical hemostasis for patients with secondary hemorrhagic risk from visceral trauma in the context of a massive influx of victims.

Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Language: en

Keywords

Abdominal trauma; Damage control surgery; Massive influx of casualties; Road accident; Terrorist attack