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World Journal of Emergency Surgery: WJES

Falco Hietbrink, Lonneke G Bode, Louis Riddez, Luke P H Leenen, Marijke R van Dijk
BACKGROUND: Necrotizing fasciitis is an uncommon, rapidly progressive and potential lethal condition. Over the last decade time to surgery decreased and outcome improved, most likely due to increased awareness and more timely referral. Early recognition is key to improve mortality and morbidity. However, early referral frequently makes it a challenge to recognize this heterogeneous disease in its initial stages. Signs and symptoms might be misleading or absent, while the most prominent skin marks might be in discrepancy with the position of the fascial necrosis...
2016: World Journal of Emergency Surgery: WJES
Federico Coccolini, Fausto Catena, Ernest E Moore, Rao Ivatury, Walter Biffl, Andrew Peitzman, Raul Coimbra, Sandro Rizoli, Yoram Kluger, Fikri M Abu-Zidan, Marco Ceresoli, Giulia Montori, Massimo Sartelli, Dieter Weber, Gustavo Fraga, Noel Naidoo, Frederick A Moore, Nicola Zanini, Luca Ansaloni
The severity of liver injuries has been universally classified according to the American Association for the Surgery of Trauma (AAST) grading scale. In determining the optimal treatment strategy, however, the haemodynamic status and associated injuries should be considered. Thus the management of liver trauma is ultimately based on the anatomy of the injury and the physiology of the patient. This paper presents the World Society of Emergency Surgery (WSES) classification of liver trauma and the management Guidelines...
2016: World Journal of Emergency Surgery: WJES
Pepijn Krielen, Barend A van den Beukel, Martijn W J Stommel, Harry van Goor, Chema Strik, Richard P G Ten Broek
BACKGROUND: Previous research on the costs of treatment for ASBO is outdated and often based on reimbursements, rather than true healthcare provider costs of the admission and related interventions. An accurate estimate of the true costs of treatment is necessary to understand the healthcare burden and to model cost-efficacy of adhesion strategies. The aim of this study was to provide an accurate cost estimate of the in-hospital costs for treatment of adhesive small bowel obstruction (ASBO) using micro-costing methods...
2016: World Journal of Emergency Surgery: WJES
Yuki Imaoka, Toshiyuki Itamoto, Yuji Takakura, Takahisa Suzuki, Satoshi Ikeda, Takashi Urushihara
BACKGROUND: Our previous retrospective study revealed the three preoperative predictors of complicated appendicitis (perforated or gangrenous appendicitis), which are body temperature ≥37.4 °C, C-reactive protein ≥4.7 mg/dl, and fluid collection surrounding the appendix on computed tomography. We reported here an additional prospective study to verify our ability to predict complicated appendicitis using the three preoperative predictors and thus facilitate better informed decisions regarding emergency surgery during night or holiday shifts...
2016: World Journal of Emergency Surgery: WJES
F Van der Cruyssen, A Manzelli
BACKGROUND: The spleen is the second most commonly injured organ in cases of abdominal trauma. Management of splenic injury depends on the clinical status of the patient and can include nonoperative management (NOM), splenic artery embolization (SAE), surgery (operative splenic salvage or splenectomy), or a combination of these treatments. In nonoperatively managed cases, SAE is sometimes used to control haemorrhage. However, the indications for SAE have not been clearly defined and, in some cases, the potential complications of the procedure may outweigh its benefits...
2016: World Journal of Emergency Surgery: WJES
Alan L Beal, Mark N Ahrendt, Eric D Irwin, John W Lyng, Steven V Turner, Christopher A Beal, Matthew T Byrnes, Greg A Beilman
BACKGROUND: We evaluated the ability of experienced trauma surgeons to accurately predict specific blunt injuries, as well as patient disposition from the emergency department (ED), based only on the initial clinical evaluation and prior to any imaging studies. It would be hypothesized that experienced trauma surgeons' initial clinical evaluation is accurate for excluding life-threatening blunt injuries and for appropriate admission triage decisions. METHODS: Using only their history and physical exam, and prior to any imaging studies, three (3) experienced trauma surgeons, with a combined Level 1 trauma experience of over 50 years, predicted injuries in patients with an initial GCS (Glasgow Coma Score) of 14-15...
2016: World Journal of Emergency Surgery: WJES
Yoshimitsu Izawa, Shuji Hishikawa, Tomohiro Muronoi, Keisuke Yamashita, Hiroyuki Maruyama, Masayuki Suzukawa, Alan Kawarai Lefor
BACKGROUND: Live tissue models are considered the most useful simulation for training in the management for hemostasis of penetrating injuries. However, these models are expensive, with limited opportunities for repetitive training. Ex-vivo models using tissue and a fluid pump are less expensive, allow repetitive training and respect ethical principles in animal research. The purpose of this study is to objectively evaluate the effectiveness of ex-vivo training with a pump, compared to live animal model training...
2016: World Journal of Emergency Surgery: WJES
Antonio Biondi, Carla Di Stefano, Francesco Ferrara, Angelo Bellia, Marco Vacante, Luigi Piazza
BACKGROUND: Appendectomy is the most common surgical procedure performed in emergency surgery. Because of lack of consensus about the most appropriate technique, appendectomy is still being performed by both open (OA) and laparoscopic (LA) methods. In this retrospective analysis, we aimed to compare the laparoscopic approach and the conventional technique in the treatment of acute appendicitis. METHODS: Retrospectively collected data from 593 consecutive patients with acute appendicitis were studied...
2016: World Journal of Emergency Surgery: WJES
Nicola de'Angelis, Francesco Esposito, Riccardo Memeo, Vincenzo Lizzi, Aleix Martìnez-Pérez, Filippo Landi, Pietro Genova, Fausto Catena, Francesco Brunetti, Daniel Azoulay
AIMS: Due to the increasing number of solid organs transplantations, emergency abdominal surgery in transplanted patients is becoming a relevant challenge for the general surgeon. The aim of this systematic review of the literature is to analyze morbidity and mortality of emergency abdominal surgery performed in transplanted patients for graft-unrelated surgical problems. METHODS: The literature search was performed on online databases with the time limit 1990-2015...
2016: World Journal of Emergency Surgery: WJES
Marco Ceresoli, Federico Coccolini, Giulia Montori, Fausto Catena, Massimo Sartelli, Luca Ansaloni
OBJECTIVE: Purulent peritonitis from acute left colon diverticulitis is a relatively common presentation of diverticular disease; historically the treatment was the Hartmann procedure. Laparoscopic peritoneal lavage has been proposed as a lesser invasive treatment option with great interest and debate among surgeons and with contrasting results. The aim of this meta-analysis was to compare the results of sigmoid resection with laparoscopic lavage. METHODS: A systematic review was performed to select randomized controlled trials comparing laparoscopic lavage versus resection in Hinchey III diverticulitis...
2016: World Journal of Emergency Surgery: WJES
Nan-Ping Yang, Dinh-Van Phan, Yi-Hui Lee, Jin-Chyr Hsu, Ren-Hao Pan, Chien-Lung Chan, Nien-Tzu Chang, Dachen Chu
BACKGROUND: Epidemiological study was needed to evaluate trends in emergency department (ED) utilization that could be taken into account when making policy decisions regarding the delivery and distribution of medical resources. METHODS: A retrospective fixed-cohort study of emergency medical utilization from 2001 to 2010 was performed based on one-million people sampled in 2010 in Taiwan. Focusing on traumatic cases, the annual incidences in various groups split according to sex and age were calculated, and further information regarding location of trauma and type of trauma was obtained...
2016: World Journal of Emergency Surgery: WJES
Gaby Jabbour, Ayman El-Menyar, Ruben Peralta, Nissar Shaikh, Husham Abdelrahman, Insolvisagan Natesa Mudali, Mohamed Ellabib, Hassan Al-Thani
BACKGROUND: Necrotizing fasciitis (NF) is a fatal aggressive infectious disease. We aimed to assess the major contributing factors of mortality in NF patients. METHODS: A retrospective study was conducted at a single surgical intensive care unit between 2000 and 2013. Patients were categorized into 2 groups based on their in-hospital outcome (survivors versus non-survivors). RESULTS: During a14-year period, 331 NF patients were admitted with a mean age of 50...
2016: World Journal of Emergency Surgery: WJES
YongHun Kim, WooSurng Lee
BACKGROUND: Single-port laparoscopic appendectomy (SPLA) has the advantage of minimizing abdominal incision scars with patient satisfaction. However, it has the following disadvantages: it provides a narrower surgical field than conventional laparoscopic appendectomy, which requires a considerably longer operative time to achieve surgical skills. This study was conducted to evaluate the learning curve for SPLA. METHODS: This study included a total of 120 patients with acute abdomen who visited our emergency department and were diagnosed with acute appendicitis between March 2013 and February 2015...
2016: World Journal of Emergency Surgery: WJES
Fikri M Abu-Zidan
BACKGROUND: Some surgeons may lack proper experience in abdominal packing. Overpacking may directly compress the inferior vena cava (IVC). This reduces the venous return and possibly causes hypotension. Here, a new on table Point-of-Care Ultrasound application that has been recently used to assess the effect of abdominal packing on the IVC diameter is described. Following abdominal packing, a small print convex array probe with low frequency (2-5 MHz) is used to visualize the IVC. Using the B mode, the IVC can be directly evaluated through a hepatic window between the ribs...
2016: World Journal of Emergency Surgery: WJES
Massimo Sartelli, Fausto Catena, Luca Ansaloni, Federico Coccolini, Ewen A Griffiths, Fikri M Abu-Zidan, Salomone Di Saverio, Jan Ulrych, Yoram Kluger, Ofir Ben-Ishay, Frederick A Moore, Rao R Ivatury, Raul Coimbra, Andrew B Peitzman, Ari Leppaniemi, Gustavo P Fraga, Ronald V Maier, Osvaldo Chiara, Jeffry Kashuk, Boris Sakakushev, Dieter G Weber, Rifat Latifi, Walter Biffl, Miklosh Bala, Aleksandar Karamarkovic, Kenji Inaba, Carlos A Ordonez, Andreas Hecker, Goran Augustin, Zaza Demetrashvili, Renato Bessa Melo, Sanjay Marwah, Sanoop K Zachariah, Vishal G Shelat, Michael McFarlane, Miran Rems, Carlos Augusto Gomes, Mario Paulo Faro, Gerson Alves Pereira Júnior, Ionut Negoi, Yunfeng Cui, Norio Sato, Andras Vereczkei, Giovanni Bellanova, Arianna Birindelli, Isidoro Di Carlo, Kenneth Y Kok, Mahir Gachabayov, Georgios Gkiokas, Konstantinos Bouliaris, Elif Çolak, Arda Isik, Daniel Rios-Cruz, Rodolfo Soto, Ernest E Moore
Acute left sided colonic diverticulitis is one of the most common clinical conditions encountered by surgeons in acute setting. A World Society of Emergency Surgery (WSES) Consensus Conference on acute diverticulitis was held during the 3rd World Congress of the WSES in Jerusalem, Israel, on July 7th, 2015. During this consensus conference the guidelines for the management of acute left sided colonic diverticulitis in the emergency setting were presented and discussed. This document represents the executive summary of the final guidelines approved by the consensus conference...
2016: World Journal of Emergency Surgery: WJES
Jakub Kenig, Piotr Wałęga, Urszula Olszewska, Aleksander Konturek, Wojciech Nowak
BACKGROUND: Older patients experience a higher incidence of postoperative complications after cholecystectomy compared with younger patients. However, most studies have not considered patient frailty, particularly regarding emergency cholecystectomy. The aim of this prospective study was to evaluate outcomes in frail older patients eligible for elective and emergency cholecystectomy. METHODS: Preoperative Geriatric Assessment (GA) was performed in consecutive patients aged 65+ years, operated for biliary disease...
2016: World Journal of Emergency Surgery: WJES
Suhail Hakim, Khalid Ahmed, Ayman El-Menyar, Gaby Jabbour, Ruben Peralta, Syed Nabir, Ahammed Mekkodathil, Husham Abdelrahman, Ammar Al-Hassani, Hassan Al-Thani
BACKGROUND: Degloving soft tissue injuries (DSTIs) are serious surgical conditions. We aimed to evaluate the pattern, management and outcome of DSTIs in a single institute. METHODS: A retrospective analysis was performed for patients admitted with DSTIs from 2011to 2013. Presentation, management and outcomes were analyzed according to the type of DSTI. RESULTS: Of 178 DSTI patients, 91 % were males with a mean age of 30.5 ± 12.8. Three-quarter of cases was due to traffic-related injuries...
2016: World Journal of Emergency Surgery: WJES
Salomone Di Saverio, Arianna Birindelli, Micheal D Kelly, Fausto Catena, Dieter G Weber, Massimo Sartelli, Michael Sugrue, Mark De Moya, Carlos Augusto Gomes, Aneel Bhangu, Ferdinando Agresta, Ernest E Moore, Kjetil Soreide, Ewen Griffiths, Steve De Castro, Jeffry Kashuk, Yoram Kluger, Ari Leppaniemi, Luca Ansaloni, Manne Andersson, Federico Coccolini, Raul Coimbra, Kurinchi S Gurusamy, Fabio Cesare Campanile, Walter Biffl, Osvaldo Chiara, Fred Moore, Andrew B Peitzman, Gustavo P Fraga, David Costa, Ronald V Maier, Sandro Rizoli, Zsolt J Balogh, Cino Bendinelli, Roberto Cirocchi, Valeria Tonini, Alice Piccinini, Gregorio Tugnoli, Elio Jovine, Roberto Persiani, Antonio Biondi, Thomas Scalea, Philip Stahel, Rao Ivatury, George Velmahos, Roland Andersson
Acute appendicitis (AA) is among the most common cause of acute abdominal pain. Diagnosis of AA is challenging; a variable combination of clinical signs and symptoms has been used together with laboratory findings in several scoring systems proposed for suggesting the probability of AA and the possible subsequent management pathway. The role of imaging in the diagnosis of AA is still debated, with variable use of US, CT and MRI in different settings worldwide. Up to date, comprehensive clinical guidelines for diagnosis and management of AA have never been issued...
2016: World Journal of Emergency Surgery: WJES
Massimo Sartelli, Dieter G Weber, Etienne Ruppé, Matteo Bassetti, Brian J Wright, Luca Ansaloni, Fausto Catena, Federico Coccolini, Fikri M Abu-Zidan, Raul Coimbra, Ernest E Moore, Frederick A Moore, Ronald V Maier, Jan J De Waele, Andrew W Kirkpatrick, Ewen A Griffiths, Christian Eckmann, Adrian J Brink, John E Mazuski, Addison K May, Rob G Sawyer, Dominik Mertz, Philippe Montravers, Anand Kumar, Jason A Roberts, Jean-Louis Vincent, Richard R Watkins, Warren Lowman, Brad Spellberg, Iain J Abbott, Abdulrashid Kayode Adesunkanmi, Sara Al-Dahir, Majdi N Al-Hasan, Ferdinando Agresta, Asma A Althani, Shamshul Ansari, Rashid Ansumana, Goran Augustin, Miklosh Bala, Zsolt J Balogh, Oussama Baraket, Aneel Bhangu, Marcelo A Beltrán, Michael Bernhard, Walter L Biffl, Marja A Boermeester, Stephen M Brecher, Jill R Cherry-Bukowiec, Otmar R Buyne, Miguel A Cainzos, Kelly A Cairns, Adrian Camacho-Ortiz, Sujith J Chandy, Asri Che Jusoh, Alain Chichom-Mefire, Caroline Colijn, Francesco Corcione, Yunfeng Cui, Daniel Curcio, Samir Delibegovic, Zaza Demetrashvili, Belinda De Simone, Sameer Dhingra, José J Diaz, Isidoro Di Carlo, Angel Dillip, Salomone Di Saverio, Michael P Doyle, Gereltuya Dorj, Agron Dogjani, Hervé Dupont, Soumitra R Eachempati, Mushira Abdulaziz Enani, Valery N Egiev, Mutasim M Elmangory, Paula Ferrada, Joseph R Fitchett, Gustavo P Fraga, Nathalie Guessennd, Helen Giamarellou, Wagih Ghnnam, George Gkiokas, Staphanie R Goldberg, Carlos Augusto Gomes, Harumi Gomi, Manuel Guzmán-Blanco, Mainul Haque, Sonja Hansen, Andreas Hecker, Wolfgang R Heizmann, Torsten Herzog, Adrien Montcho Hodonou, Suk-Kyung Hong, Reinhold Kafka-Ritsch, Lewis J Kaplan, Garima Kapoor, Aleksandar Karamarkovic, Martin G Kees, Jakub Kenig, Ronald Kiguba, Peter K Kim, Yoram Kluger, Vladimir Khokha, Kaoru Koike, Kenneth Y Y Kok, Victory Kong, Matthew C Knox, Kenji Inaba, Arda Isik, Katia Iskandar, Rao R Ivatury, Maurizio Labbate, Francesco M Labricciosa, Pierre-François Laterre, Rifat Latifi, Jae Gil Lee, Young Ran Lee, Marc Leone, Ari Leppaniemi, Yousheng Li, Stephen Y Liang, Tonny Loho, Marc Maegele, Sydney Malama, Hany E Marei, Ignacio Martin-Loeches, Sanjay Marwah, Amos Massele, Michael McFarlane, Renato Bessa Melo, Ionut Negoi, David P Nicolau, Carl Erik Nord, Richard Ofori-Asenso, AbdelKarim H Omari, Carlos A Ordonez, Mouaqit Ouadii, Gerson Alves Pereira Júnior, Diego Piazza, Guntars Pupelis, Timothy Miles Rawson, Miran Rems, Sandro Rizoli, Claudio Rocha, Boris Sakakhushev, Miguel Sanchez-Garcia, Norio Sato, Helmut A Segovia Lohse, Gabriele Sganga, Boonying Siribumrungwong, Vishal G Shelat, Kjetil Soreide, Rodolfo Soto, Peep Talving, Jonathan V Tilsed, Jean-Francois Timsit, Gabriel Trueba, Ngo Tat Trung, Jan Ulrych, Harry van Goor, Andras Vereczkei, Ravinder S Vohra, Imtiaz Wani, Waldemar Uhl, Yonghong Xiao, Kuo-Ching Yuan, Sanoop K Zachariah, Jean-Ralph Zahar, Tanya L Zakrison, Antonio Corcione, Rita M Melotti, Claudio Viscoli, Perluigi Viale
Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance...
2016: World Journal of Emergency Surgery: WJES
Frederico Teixeira, Carlos Augusto Metidieri Menegozzo, Sérgio Dias do Couto Netto, Renato S Poggeti, Francisco de Sales Collet E Silva, Dario Birolini, Celso de Oliveira Bernini, Edivaldo Massazo Utiyama
BACKGROUND: Selective management of penetrating neck injuries has been considered the standard of care with minimal risks to patient safety. In a previous non-randomized prospective study conducted at our center, selective management proved to be safe and reduced unnecessary exploratory cervicotomies. In the present study, the role of clinical examination and selective diagnostic tests were assessed by reviewing demographic and clinical data. A comparison of results between two groups (mandatory surgical exploration versus selective surgical exploration) was made to check the safety of selective management in terms of the rates of morbidity and mortality...
2016: World Journal of Emergency Surgery: WJES
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