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In recent years, there has been a steady increase in injuries all over the world. Man-made and natural disasters, local military conflicts, transport and industrial accidents in 50-60% of cases of all injuries lead to combined and multiple injuries to organs and systems of the human body, and, as a result, to high sanitary losses in the first hours and days [1,2,5,13,19,21]. This article discusses intestinal injuries in combined abdominal trauma.

Intro -- Title Page -- Copyright -- Contents -- Foreword -- Contributors -- Introduction -- Historical Perspectives -- 1. In search of the unseen wound -- 2. Atrocity propaganda and moral injury -- Personal Perspectives -- 3. A commander's perspective -- 4. A combatant's view -- 5. A chaplain's experience -- Ethical Perspectives -- 6. Moral ambiguity and ethical dilemma -- 7. Conceptual distinctions -- 8. Moral trauma and moral degradation -- 9. 'Dents in the Soul'? -- Psychological Perspectives -- 10. The utility of moral injury -- 11. Dealing with horror -- Practical Perspectives -- 12. Is moral injury the answer? -- 13. Moral status and reintegration -- Religious Perspectives -- 14. Moral injury: whose responsibility? -- 15. The influence of religious conviction -- Postscript -- Notes

Cover -- Half Title -- Title Page -- Copyright -- Dedication -- Table of Contents -- Foreword -- Friday, April 26, 2002 -- Near the Close of 1981 -- The Months Leading Up to the Accident -- 10 Years Before -- Back to the Present in 1982 -- 1983 -- 1985 -- Pre-Brain Damage -- Post Brain Damage -- Back to the Present in 1985 -- 1986 -- Values -- September 1987 -- Forced to Go to Court -- 9 Months from the Close of Trial to Judgment -- Dr. Fisher -- From a Pulpit in October 1989 -- Trying to Serve Post-Judgment -- November 20th 2003 -- 2006 -- 2007 to 2015.

In the past 20 years, there has been an increase in the incidence of head injuries caused by gunshot wounds. Penetrating brain injury is a traumatic brain injury caused by high-velocity projectiles or low-velocity sharp objects. A wound in which the projectile breaches the cranium but does not exit is referred as a penetrating wound, and an injury in which the projectile passes entirely through the head, leaving both entrance and exit wounds, is referred to as a perforating wound. A large number of these patients who survive their initial wounding will nevertheless expire shortly after admission to the hospital. Until the introduction of aseptic surgery in the last quarter of the nineteenth century, penetrating missile injuries of the brain were almost universally fatal. We have learned a great deal about gunshot wounds and their management from military experience gained during times of war, when a large number of firearm-related casualties are treated in a short period of time. Newly designed protective body armor has reduced the incidence of penetrating brain injuries significantly. Many of the victims in the vicinity of a cased explosive or an improvised explosive device will incur injuries by fragments. Blast injury is a common mechanism of traumatic brain injury among soldiers serving in war zone. Each war has had different lessons to teach. World War I for example, proved the efficacy of vigorous surgical intervention. During World War II, the importance of initial dural repair and antibiotic medication was first, debated, then acknowledged, and finally, universally accepted. The incidence of blast-induced traumatic brain injury has increased substantially in recent military conflicts. Blast-induced neurotrauma is the term given to describe an injury to the brain that occurs after exposure to a blast. Resent conflict has exposed military personnel to sophisticated explosive devices generating blast overpressure that results in secondary cellular and molecular insults to the brain parenchyma akin to diffuse brain injury. In soldiers with varying amounts of body armor, the pattern is quite different. What had previously been fatal penetrating brain injuries now become treatable brain injuries as a consequence of secondary damping of energy by the helmet. Traumatic brain injury is not prevented by a protective helmet. High- and low-frequency blast waves disrupt the blood-brain barrier and produce massive brain swelling in a very short time, thereby necessitating urgent decompressive craniectomy, and when low in energy, such blast waves may result in cytoskeletal and diffuse axonal injury that leads to neurodegeneration. Penetrating traumatic brain injury is typically identified and treated immediately mild traumatic brain injury may be missed, particularly in the presence of other more obvious injuries. In recent years there has been an apparent paradigm shift of scientific interest in long-term effects of mild traumatic brain injury and its contribution to posttraumatic stress disorder. The introduction of Guidelines for the Management of Penetrating Brain Injury has revolutionized the medical and surgical management of penetrating brain injury during the last decade. There has been a paradigm shift toward a less aggressive debridement of deep seated fragments and a more aggressive antibiotics prophylaxis in an effort to improve outcomes.

Traumatic Brain Injury provides practical, neurological guidance to the diagnosis and management of patients who suffer from traumatic brain injury. Taking a "patient journey" in traumatic brain injury, from prehospital management to the emergency department, into rehabilitation and finally reemergence in the community, it demonstrates how neurologists can facilitate recovery at all points along the way. It provides guidelines and algorithms to help support patients with brain injury within trauma centers, in posttraumatic care following discharge, and with mild traumatic brain injury not requiring immediate hospitalization. From an international team of expert editors and contributors, Traumatic Brain Injury is a valuable resource for neurologists, trainee neurologists, and others working with patients with traumatic brain injury.

There is an increasing incidence of military traumatic brain injury (TBI), and similar injuries are seen in civilians in war zones or terrorist incidents. Indeed, blast-induced mild TBI has been referred to as the signature injury of the conflicts in Iraq and Afghanistan. Assessment involves schemes that are common in civilcian practice but, in common with civilian TBI, takes little account of information available from modern imaging (particularly diffusion tensor magnetic resonance imaging) and emerging biomarkers. The efficient logistics of clinical care delivery in the field may have a role in optimizing outcome. Clinical care has much in common with civilian TBI, but intracranial pressure monitoring is not always available, and protocols need to be modified to take account of this. In addition, severe early oedema has led to increasing use of decompressive craniectomy, and blast TBI may be associated with a higher incidence of vasospasm and pseudoaneurysm formation. Visual and/or auditory deficits are common, and there is a significant risk of post-traumatic epilepsy. TBI is rarely an isolated finding in this setting, and persistent post-concussive symptoms are commonly associated with post-traumatic stress disorder and chronic pain, a constellation of findings that has been called the polytrauma clinical triad.