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pancreatic trauma

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https://www.readbyqxmd.com/read/28930953/proposed-clinical-pathway-for-nonoperative-management-of-high-grade-pediatric-pancreatic-injuries-based-on-a-multicenter-analysis-a-pediatric-trauma-society-collaborative
#1
Bindi J Naik-Mathuria, Eric H Rosenfeld, Ankush Gosain, Randall Burd, Richard A Falcone, Rajan Thakkar, Barbara Gaines, David Mooney, Mauricio Escobar, Mubeen Jafri, Anthony Stallion, Denise B Klinkner, Robert Russell, Brendan Campbell, Rita V Burke, Jeffrey Upperman, David Juang, Shawn St Peter, Stephon J Fenton, Marianne Beaudin, Hale Wills, Adam Vogel, Stephanie Polites, Adam Pattyn, Christine Leeper, Laura V Veras, Ilan Maizlin, Shefali Thaker, Alexis Smith, Megan Waddell, Joseph Drews, James Gilmore, Lindsey Armstrong, Alexis Sandler, Suzanne Moody, Brandon Behrens, Laurence Carmant
BACKGROUND: Guidelines for nonoperative management (NOM) of high-grade pancreatic injuries in children have not been established, and wide practice variability exists. The purpose of this study was to evaluate common clinical strategies across multiple pediatric trauma centers to develop a consensus-based standard clinical pathway. METHODS: A multicenter, retrospective review was conducted of children with high-grade (American Association of Surgeons for Trauma grade III-V) pancreatic injuries treated with NOM between 2010 and 2015...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28902777/operative-versus-nonoperative-management-of-blunt-pancreatic-trauma-in-children-a-systematic-review
#2
Ezra Y Koh, Daan van Poll, J Carel Goslings, Olivier R Busch, Erik A Rauws, Matthijs W Oomen, Marc G Besselink
The aim of this study was to compare operative versus nonoperative management of blunt pancreatic trauma in children. A systematic literature search was performed. Studies including children with blunt pancreatic injuries classified according to the American Association for the Surgery of Trauma classification were included. The primary outcome was pseudocyst formation. After screening 526 studies, 23 studies with 928 patients were included. Sufficient data were available for 674 patients (73%). Of 309 patients with grade I or II injuries, 258 (83%) were initially managed nonoperatively with a 96% success rate...
October 2017: Pancreas
https://www.readbyqxmd.com/read/28886723/pancreatic-injury-in-children-a-case-report-and-review-of-the-literature
#3
Fayza Haider, Mohammed Amin Al Awadhi, Eizat Abrar, Mooza Al Dossari, Hasan Isa, Husain Nasser, Hakima Al Hashimi, Sharif Al Arayedh
BACKGROUND: Trauma is the main cause of morbidity and mortality in the pediatric population. Blunt trauma to the abdomen accounts for the majority of abdominal injuries in children. Pancreatic injury, although uncommon (2 to 9%), is the fourth most common solid organ injury. Unlike other solid organ injuries, pancreatic trauma may be subtle and difficult to diagnose. Computed tomography currently is the imaging modality of choice. As the incidence of pancreatic injury in children sustaining blunt abdominal trauma is low, management remains a challenge...
September 9, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28886391/combined-pancreatic-and-duodenal-transection-injury-a-case-report
#4
Simbarashe Gift Mungazi, Chenesa Mbanje, Onesai Chihaka, Noah Madziva
INTRODUCTION: Combined pancreatic-duodenal injuries in blunt abdominal trauma are rare. These injuries are associated with high morbidity and mortality, and their emergent management is a challenge. CASE PRESENTATION: We report a case of combined complete pancreatic (through the neck) and duodenal (first part) transections in a 24-year-old male secondary to blunt abdominal trauma following a motor vehicle crash. The duodenal stumps were closed separately and a gastrojejunostomy performed for intestinal continuity...
August 31, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28871350/-approach-to-liver-spleen-and-pancreatic-injuries-including-damage-control-surgery-of-terrorist-attacks
#5
REVIEW
G A Stavrou, M J Lipp, K J Oldhafer
BACKGROUND: Terrorist attacks have outreached to Europe with more and more attacks on civilians. Derived from war surgery experience and from lessons learned from major incidents, it seems mandatory for every surgeon to improve understanding of the special circumstances of trauma following a terrorist attack and its' management. METHOD: A short literature review is followed by outlining the damage control surgery (DCS) principle for each organ system with practical comments from the perspective of a specialized hepatobiliary (HPB) surgery unit...
September 4, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28867641/a-comparison-of-the-management-of-blunt-splenic-injury-in-children-and-young-people-a-new-south-wales-population-based-retrospective-study
#6
Susan E Adams, Andrew Holland, Julie Brown
The importance and safety of non-operative management (NOM) of Blunt Splenic Injury (BSI) has been established in children and adults over recent decades. However, studies have shown higher operation rates in adults. There is international evidence that when children are managed in adult centres, operation rates are higher while adolescents in paediatric centres, are operated on in line with paediatric guidelines. This difference between children and young adults, and the factors responsible, have not been examined in New South Wales (NSW)...
August 14, 2017: Injury
https://www.readbyqxmd.com/read/28843715/safety-and-efficacy-of-angioembolisation-followed-by-endoscopic-ultrasound-guided-transmural-drainage-for-pancreatic-fluid-collections-associated-with-arterial-pseudoaneurysm
#7
Surinder S Rana, Amit Kumar, Anupam Lal, Ravi Sharma, Mandeep Kang, Ujjwal Gorsi, Rajesh Gupta
BACKGROUND AND AIMS: Arterial pseudoaneurysms associated with pancreatic fluid collections (PFC's) are serious complication of pancreatitis. There is insufficient data on safety of endoscopic ultrasound (EUS) guided drainage in these patients. AIM: To retrospectively analyze results of combination of angioembolisation followed by EUS guided transmural drainage of PFC's associated with pseudoaneurysms. METHODS: Retrospective analysis of data base of eight patients (all males; mean age: 36...
August 19, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28842736/-minimally-invasive-and-robot-assisted-surgery-for-pancreatic-cystic-tumors
#8
REVIEW
T Welsch, M Distler, J Weitz
BACKGROUND: The indications for resection of pancreatic cystic lesions (PCL) are often complex and the operative risk has to be balanced against the risk of malignant transformation. The aim of the study was to provide a synopsis of the current treatment results of minimally invasive surgery for PCL. METHODS: A systematic literature search was performed using the Medline database (PubMed). Subsequently, the retrieved literature was selectively reviewed. RESULTS: No published prospective randomized controlled trials have yet addressed the comparison of open and minimally invasive surgery of PCL; however, retrospective case studies have demonstrated the feasibility, safety and a comparable morbidity after minimally invasive distal pancreatectomy (DP), pancreatoduodenectomy (PD), central (CP) or total pancreatectomy and enucleation...
August 25, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28814248/pediatric-abdominal-trauma
#9
Tim Lynch
Abdominal trauma is present in approximately 25% of pediatric patients with major trauma and is the most common cause of unrecognized fatal injury in children. Pediatric abdominal trauma is typically blunt in nature with the spleen being the most common organ injured. Non-operative management is employed in over 95% of patients. Penetrating injuries are less common but often require operative management. Knowledge of specific mechanisms of injury aids the clinician in the diagnosis of specific injuries. Computed tomography (CT) is the gold standard in the identification of intra-abdominal injury...
August 14, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28780610/pancreatic-leaks-and-fistulae-an-endoscopy-oriented-classification
#10
REVIEW
Massimiliano Mutignani, Stefanos Dokas, Alberto Tringali, Edoardo Forti, Francesco Pugliese, Marcello Cintolo, Raffaele Manta, Lorenzo Dioscoridi
BACKGROUND: Pancreatic leaks occur as a complication of upper gastrointestinal surgery, acute pancreatitis, or abdominal trauma. Pancreatic fistulas and leaks are primarily managed conservatively. Overall, conservative measures are successful in more than half of cases. Whenever conservative treatment is not efficient, surgery is usually considered the treatment of choice. Nowadays however, endoscopic treatment is being increasingly considered and employed in many cases, as a surgery sparing intervention...
August 5, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28780503/late-mortality-after-acute-hypoxic-respiratory-failure
#11
Hallie C Prescott, Michael W Sjoding, Kenneth M Langa, Theodore J Iwashyna, Daniel F McAuley
BACKGROUND: Acute hypoxic respiratory failure (AHRF) is associated with significant acute mortality. It is unclear whether later mortality is predominantly driven by pre-existing comorbid disease, the acute inciting event or is the result of AHRF itself. METHODS: Observational cohort study of elderly US Health and Retirement Study (HRS) participants in fee-for-service Medicare (1998-2012). Patients hospitalised with AHRF were matched 1:1 to otherwise similar adults who were not currently hospitalised and separately to patients hospitalised with acute inciting events (pneumonia, non-pulmonary infection, aspiration, trauma, pancreatitis) that may result in AHRF, here termed at-risk hospitalisations...
August 5, 2017: Thorax
https://www.readbyqxmd.com/read/28757865/emergency-backwards-whipple-for-bleeding-formidable-and-definitive-surgery
#12
Cristian Lupascu, Ana Trofin, Mihai Zabara, Alexandra Vornicu, Ramona Cadar, Nutu Vlad, Oana Apopei, Valentin Grigorean, Corina Lupascu-Ursulescu
INTRODUCTION: During the past decades, the safety of pancreatoduodenectomy has improved, with low mortality and reduced morbidity, particularly in centers with extensive experience. Emergency pancreatoduodenectomy is an uncommon event, for treatment of pancreaticoduodenal trauma, bleeding, or perforation. We herein present a single center experience concerning nontrauma emergency pancreatoduodenectomy for pancreaticoduodenal bleeding. METHODS: From January 2007 to December 2015, from a population of 134 PD (70 males and 64 females, mean age 62...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28733741/tips-and-tricks-of-splenic-vessel-preservation-during-laparoscopic-distal-pancreatectomy
#13
Claire Goumard, Satoshi Ogiso, Masayuki Okuno, Jason B Fleming, Michael Kim, Ching-Wei D Tzeng, Jean-Nicolas Vauthey, Jeffrey E Lee, Claudius Conrad
BACKGROUND: While a laparoscopic approach can minimize postoperative morbidity in splenic vessel preserving (SVP) distal pancreatectomy (DP), this procedure can be technically challenging. A systematic approach to SVP minimizes the chances of vascular injury and maximizes the chances of successful splenic preservation. This video demonstrates a laparoscopic DP with SVP, highlighting technical tips and tricks that optimize the chances for SVP. PATIENT: The patient is a 14-year-old male with an incidentally discovered pancreatic tail mass...
July 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28732002/-gastrointestinal-stromal-tumor-in-young-pregnant-woman-case-report
#14
Walker Del Cid Jove Oblitas, Miguel Joseph Abril Barreda
Female patient, 28 years old, with a gestation of 14 weeks, natural and from Ilo-Moquegua. Came with a time of disease 4 days with hematemesis, melena, epigastric pain and syncope. Background of colonic resection for peritonitis due to trauma 20 years ago; upper gastrointestinal bleeding three years ago; paternal grandparents died of gastric cancer; chronic gastritis diagnosed from 19 year old. In laboratory studies hemoglobin of 9.2. In the upper gastrointestinal endoscopy was found absence of active upper gastrointestinal bleeding, a large tumor in proximal body toward greater curvature and posterior wall, 8 cm in diameter approximately, lobed appearance, with most of the mucosal surface unscathed is evidence, areas of ulceration of 2-3 mm covered with fibrin (biopsies taken), hard consistency, tent sign (positive) and cushionsign (negative)...
April 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/28653162/completely-intracorporeal-handsewn-laparoscopic-anastomoses-during-whipple-procedure
#15
Giovanni Dapri, Nigel Antonio Bascombe, Leonardo Gerard, Carla Samaniego Ballart, Carlos Gimenez Viñas, Sven Saussez
BACKGROUND: Whipple procedure has been described since 1935,1 using classic open surgery. With the advent of minimally invasive surgery (MIS), it has been described to be feasible using the latest technology.2 (,) 3 In this video the authors report a full laparoscopic Whipple procedure, realizing the three anastomoses by intracorporeal handsewn method. VIDEO: A 70-year-old man who presented with adenocarcinoma of the ampulla of Vater, infiltrating the pancreatic parenchyma underwent to a laparoscopic Whipple...
September 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28645741/chylous-ascites-due-to-idiopathic-chronic-pancreatitis-managed-with-endoscopic-stenting
#16
Amit Kumar, Harshal S Mandavdhare, Surinder S Rana, Rajesh Gupta, Vishal Sharma
Chylous ascites is an uncommon clinical entity, which usually results from congenital or acquired abnormality in proper lymphatic flow. While the common causes are related to trauma, malignancy or tuberculosis, pancreatic disorders can occasionally result in chylous ascites. Sporadic cases of chylous ascites due to acute or chronic pancreatitis or surgery for pancreatitis have been reported. The usual management is with medium chain triglycerides (MCT), total parenteral nutrition and octreotide. We report a case of a young male with idiopathic chronic pancreatitis who presented with chylous ascites which did not respond to MCT based diet and octreotide...
June 20, 2017: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/28640662/using-probiotics-in-clinical-practice-where-are-we-now-a-review-of-existing-meta-analyses
#17
Mariangela Rondanelli, Milena Anna Faliva, Simone Perna, Attilio Giacosa, Gabriella Peroni, Anna Maria Castellazzi
The scientific literature has demonstrated that probiotics have a broad spectrum of activity, although often the results are contradictory. This study provides a critical overview of the current meta-analyses that have evaluated the efficacy of probiotics in physiologic and pathological conditions, such as metabolic disease, antibiotic-associated and Clostridium difficile-associated diarrhea, IBS, constipation, IBD, chemotherapy-associated diarrhea, respiratory tract infection, ventilator-associated pneumonia, NAFLD, liver encephalopathy, periodontitis, depression, vaginosis, urinary tract infections, pancreatitis, incidence of ventilator-associated pneumonia, hospital infection and stay in ICU, mortality of post-trauma patients, necrotising enterocolitis in premature infants...
June 22, 2017: Gut Microbes
https://www.readbyqxmd.com/read/28633652/spontaneous-rupture-of-the-common-hepatic-duct-associated-with-acute-pancreatitis-a-case-report
#18
Makram Moussa, Wissem Triki, Omar Karray, Ines Marzouk, Bouchoucha Sami
BACKGROUND: Rupture of the common bile duct is a life-threatening condition, usually observed after a trauma or in association with choledocholithiasis or an obstructive tumor of the bile duct. However, a spontaneous rupture of the common bile duct is a rare entity. CASE PRESENTATION: We report a new observation of a spontaneous rupture of the common bile duct, associated with biliary peritonitis and pancreatitis, in a 15-year-old North African girl. Etiological aspects, specificities of clinical presentation, means of diagnosis, as well as surgical and perioperative management are discussed...
June 21, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28631007/how-schwann-cells-facilitate-cancer-progression-in-nerves
#19
REVIEW
Sylvie Deborde, Richard J Wong
Recent studies have demonstrated a critical role for nerves in enabling tumor progression. The association of nerves with cancer cells is well established for a variety of malignant tumors, including pancreatic, prostate and the head and neck cancers. This association is often correlated with poor prognosis. A strong partnership between cancer cells and nerve cells leads to both cancer progression and expansion of the nerve network. This relationship is supported by molecular pathways related to nerve growth and repair...
June 19, 2017: Cellular and Molecular Life Sciences: CMLS
https://www.readbyqxmd.com/read/28612150/single-versus-multiple-solid-organ-injuries-following-blunt-abdominal-trauma
#20
Ayman El-Menyar, Husham Abdelrahman, Ammar Al-Hassani, Ruben Peralta, Hiba AbdelAziz, Rifat Latifi, Hassan Al-Thani
BACKGROUND: We aimed to describe the pattern of solid organ injuries (SOIs) and analyze the characteristics, management and outcomes based on the multiplicity of SOIs. METHODS: A retrospective study in a Level 1 trauma center was conducted and included patients admitted with blunt abdominal trauma between 2011 and 2014. Data were analyzed and compared for patients with single versus multiple SOIs. RESULTS: A total of 504 patients with SOIs were identified with a mean age of 28 ± 13 years...
June 13, 2017: World Journal of Surgery
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