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https://www.readbyqxmd.com/read/29302507/blunt-trauma-pancreas-in-children-is-non-operative-management-appropriate-for-all-grades
#1
Ravi Kumar Garg, Jai Kumar Mahajan
Purpose: Blunt trauma of pancreas in children is uncommon and its management varies from observational to early operative intervention. We analysed the feasibility and outcome of non-operative management in all grades of paediatric pancreatic injuries. Methods: A total of 15 patients of pancreatic trauma seen in a Paediatric Surgery Unit were retrospectively analyzed. Results: Age of the patients ranged from 3-11 years (mean, 7.7 years). The mode of injury was local trauma in 9 children...
December 2017: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/29261593/non-operative-management-of-abdominal-solid-organ-injuries-following-blunt-trauma-in-adults-results-from-an-international-consensus-conference
#2
Stefania Cimbanassi, Osvaldo Chiara, Ari Leppaniemi, Sharon Henry, Thomas M Scalea, Kathirkamanathan Shanmuganathan, Walter Biffl, Fausto Catena, Luca Ansaloni, Gregorio Tugnoli, Elvio De Blasio, Arturo Chieregato, Giovanni Gordini, Sergio Ribaldi, Maurizio Castriconi, Patrizio Festa, Federico Coccolini, Salomone di Saverio, Antonio Galfano, Massimo Massi, Marilena Celano, Massimiliano Mutignani, Stefano Rausei, Desiree Pantalone, Antonio Rampoldi, Luca Fattori, Stefano Miniello, Sebastian Sgardello, Francesca Bindi, Federica Renzi, Fabrizio Sammartano
BACKGROUND: Non-operative management (NOM) for blunt solid organ injuries has become the standard of care for patients who are hemodynamically stable, without other indications for explorative laparotomy. Our aims were to develop evidence-based guidelines to correctly identify the indications for NOM in adult blunt trauma patient, the best and most appropriate modality for follow-up, and the best techniques to manage complications. METHODS: The literature since 2000 to 2016 was systematically screened according to PRISMA [Preferred Reporting Items for Systematic Reviews and meta-analyses] protocol...
December 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29230341/pancreatic-laceration-in-a-pediatric-patient-an-unexpected-diagnosis
#3
Michelle J Hong, Lauren M Porter, Debra D Esernio-Jenssen, Andrew C Miller, Marna Rayl Greenberg
Pediatric pancreatic injuries are rare. We present an atypical case that occurred in a 4-year-old male. The child presented with a twenty-four-hour history of vomiting that had progressed to right lower quadrant abdominal pain on examination in the emergency department. The initial differential was gastroenteritis versus appendicitis. An abnormality on the ultrasonography and an elevated lipase level eventually led to an MRI showing a complete transection through the posterior margin of the pancreas. The patient was admitted to pediatric surgery and underwent a successful distal pancreatectomy with preservation of the spleen...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/29224654/evaluation-and-management-of-blunt-solid-organ-trauma
#4
REVIEW
Jonathan G Martin, Jay Shah, Craig Robinson, Sean Dariushnia
Trauma is a leading cause of death in patients under the age of 45 and generally associated with a high kinetic energy event such as a motor vehicle accident or fall from extreme elevations. Blunt trauma can affect every organ system and major vascular structure with potentially devastating effect. When we consider abdominal solid organ injury from blunt trauma, we usually think of the liver, spleen, and kidneys. However, all of the abdominal organs, including the pancreas and adrenal glands, may be involved...
December 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29222221/acute-pancreatitis-following-oesophagogastroduodenoscopy
#5
Nnamdi Arinze Nwafo
Acute pancreatitis is a well-recognised complication of endoscopic procedures like endoscopic retrograde cholangiopancreatography but not oesophagogastroduodenoscopy (OGD). I report a case of a 33-year-old woman, admitted with severe epigastric pain and vomiting 2 hours after an elective OGD for evaluation of chronic gastrointestinal symptoms. Pancreatitis was diagnosed on the basis of elevated lipase (40 790 U/L; normal 11-82) and findings on imaging studies. Other common causes of acute pancreatitis such as gallstones, alcohol and medications were ruled out...
December 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29217902/magnitude-severity-and-outcome-of-traumatic-pancreatic-injury-at-a-level-i-trauma-center-in-india
#6
Amit Gupta, Subodh Kumar, Sanjay Kumar Yadav, Biplab Mishra, Maneesh Singhal, Atin Kumar, Pramod Garg
Pancreatic injury is an uncommon and frequently missed injury in abdominal trauma patients. However, missed pancreatic injury is associated with significant morbidity and mortality. This study was conducted to know the burden of pancreatic injury and its outcome in our setup. A retrospective analysis of 53 patients with pancreatic injury from January 2008 through March 2012 at the Jai Prakash Narayan Apex Trauma Center (JPNATC), All India Institute of Medical Sciences (AIIMS), New Delhi. Pancreatic injuries were present in 1...
December 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29199182/delayed-diagnosis-and-treatment-of-high-grade-blunt-pancreatic-trauma-case-report-and-review-of-literature
#7
Myftar Torba, Arben Gjata, Francesco Rulli, Ilir Kajo, Sotir Ceka, Tajar Asqeri
INTRODUCTION: Despite technological advancement, high grade pancreatic injuries following blunt abdominal trauma continues to remain a disease that is associated with high morbidity and mortality rates, particularly in cases of delayed diagnosis. The aim of this paper was the presentation of delayed diagnosis and treatment peculiarities of high grade pancreatic trauma and a review of literature. CASE REPORT: A 55-years old man, involved in motor vehicle crashes, was referred to our level I trauma center...
November 29, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29173964/outcomes-after-resection-versus-non-resection-management-of-penetrating-grade-iii-and-iv-pancreatic-injury-a-trauma-quality-improvement-tqip-databank-analysis
#8
Shahin Mohseni, Jeremy Holzmacher, Gabriel Sjolin, Rebecka Ahl, Babak Sarani
BACKGROUND: High-grade traumatic pancreatic injuries are associated with significant morbidity and mortality. Non-resection management is associated with fewer complications in pediatric patients. The present study evaluates outcomes following resection versus non-resection management of severe pancreatic injury caused by penetrating trauma. METHODS: A retrospective study of the Trauma Quality Improvement Program (TQIP) database was performed from 1/2010 to 12/2014...
November 21, 2017: Injury
https://www.readbyqxmd.com/read/29150368/the-utility-of-ercp-in-pediatric-pancreatic-trauma
#9
Eric H Rosenfeld, Adam M Vogel, Denise B Klinkner, Mauricio Escobar, Barbara Gaines, Robert Russell, Brendan Campbell, Hale Wills, Anthony Stallion, David Juang, Rajan K Thakkar, Jeffrey Upperman, Mubeen Jafri, Randall Burd, Bindi J Naik-Mathuria
BACKGROUND/PURPOSE: Endoscopic retrograde cholangiopancreatography (ERCP) is an adjunct for pediatric pancreatic injury management, but its use and utility in pediatric patients are unclear. We set out to evaluate the use of ERCP and its effects on outcomes. METHODS: A retrospective review was performed for children who had pancreatic injuries at 22 pediatric trauma centers between 2010 and 2015. ERCP details and outcomes were collected. Analysis was performed using descriptive statistics and Wilcoxon rank-sum tests...
October 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29147123/acute-necrotizing-pancreatitis-following-coronary-artery-angiography-a-case-report
#10
Majid Hajimaghsoudi, Faezeh Zeinali, Mehrdad Mansouri, Mohammad Hosein Dehghani
BACKGROUND: Acute pancreatitis has different etiologies from biliary stone to metabolic disturbances. Coronary angiography is one of the newly understood etiologies. CASE REPORT: This paper is about a women suffering from acute pancreatitis after coronary angiography. CONCLUSION: Embolization of cholesterol crystals due to vessel wall trauma during coronary angiography as well as contrast medium are responsible for such side effect.
May 2017: ARYA Atherosclerosis
https://www.readbyqxmd.com/read/29137016/binding-pancreaticogastrostomy-anastomosis-in-central-pancreatectomy-a-single-center-experience
#11
Pengcheng Kang, Zhidong Wang, Kaiming Leng, Xiangyu Zhong, Hao Wang, Ming Wan, Sheng Tai, Yunfu Cui
A growing number of central pancreatectomies are performed. However, reconstruction of pancreaticoenteral digestive continuity after central pancreatectomy remains debated. This study evaluates the short-term outcomes of binding pancreaticogastrostomy anastomosis in central pancreatectomy.We have reviewed our experience with 52 patients who underwent binding pancreaticogastrostomy following central pancreatectomy from February 2009 to March 2015. Indication includes 6 noninvasive intraductal papillary mucinous neoplasms, 11 neuroendocrine tumors, 12 solid pseudopapillary tumor, 9 serous cystadenoma, 6 mucinous cystadenoma, and 8 focal pancreatic traumas...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29115473/clinical-application-of-a-novel-diagnostic-scheme-including-pancreatic-%C3%AE-%C3%A2-cell-dysfunction-for-traumatic-multiple-organ-dysfunction-syndrome
#12
Zhan-Ke Wang, Rong-Jian Chen, Shi-Liang Wang, Guang-Wei Li, Zhong-Zhen Zhu, Qiang Huang, Zi-Li Chen, Fan-Chang Chen, Lei Deng, Xiao-Peng Lan, Tian Hu
A novel diagnostic scheme that includes pancreatic β‑cell dysfunction analysis for the diagnosis of traumatic multiple organ dysfunction syndrome (MODS) was investigated to assist in the early diagnosis and detection of MODS. Early intervention and treatment of MODS has been associated with a reduced mortality rate. A total of 2,876 trauma patients (including patients post‑major surgery) were admitted to the intensive care unit of the authors' hospital between December 2010 and December 2015 and enrolled in the present study...
January 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29101470/pancreatic-fracture-a-rare-complication-following-scoliosis-surgery
#13
Mélodie Juricic, Kalitha Pinnagoda, Walid Lakhal, Jérome Sales De Gauzy, Olivier Abbo
STUDY DESIGN: Grand Round case report. OBJECTIVE: We report a pancreatic fracture associated with Wirsung duct disruption, following a scoliosis surgery in a cerebral palsy adolescent. Spinal fusion surgery is the standard treatment for severe neuromuscular scoliosis. Many complications such as digestive ones account for its complexity. Postoperative acute pancreatitis is well described, although its pathophysiology remains unclear. To our knowledge, pancreatic fracture following scoliosis correction has never been described to date...
November 3, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29095150/spleen-preserving-distal-pancreatectomy-in-isolated-pancreatic-trauma
#14
Bora Barut, Felat Ciftci, Cuneyt Kayaalp
INTRODUCTION: Isolated pancreatic trauma is a rare condition and commonly come up in children or young adults.The poor initial symptoms lead to delay diagnosis and treatment. The treatment of isolated distal pancreatic trauma including the Wirsung's duct is generally distal pancreatectomy. In an emergency setting, splenectomy is a common additional organ resection requirement with the distal pancreatectomy. However, in circumstances, spleen preserving distal pancreatectomy can provide advantages in these age groups even in emergency conditions...
September 12, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28966194/open-abdomen-in-trauma-and-critical-care
#15
Eleanor R Fitzpatrick
The open abdomen technique and temporary abdominal closure after damage control surgery is fast becoming the standard of care for managing intra-abdominal bleeding and infectious or ischemic processes in critically ill patients. Expansion of this technique has evolved from damage control surgery in severely injured trauma patients to use in patients with abdominal compartment syndrome due to acute pancreatitis and other disorders. Subsequent therapies after use of the open abdomen technique and temporary abdominal closure are resuscitation in the intensive care unit and planned reoperation to manage the underlying cause of bleeding, infection, or ischemia...
October 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28948335/damage-control-surgery-for-non-traumatic-abdominal-emergencies
#16
Edouard Girard, Julio Abba, Bastien Boussat, Bertrand Trilling, Adrian Mancini, Pierre Bouzat, Christian Létoublon, Mircea Chirica, Catherine Arvieux
BACKGROUND: Damage control surgery (DCS) was a major paradigm change in the management of critically ill trauma patients and has gradually expanded in the general surgery arena, but data in this setting are still scarce. The study aim was to evaluate outcomes of DCS in patients with general surgery emergencies. METHODS: Between 2005 and 2015, 164 patients (104 men, age 66) underwent DCS for non-traumatic abdominal emergencies. The decision to perform DCS was triggered by the presence of at least one trauma DCS criterion: hypotension (<70 mmHg), hypothermia (<35 °C), acidosis (pH < 7...
September 25, 2017: World Journal of Surgery
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
#17
MULTICENTER STUDY
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
#18
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
#19
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
#20
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...
2017: International Journal of Surgery Case Reports
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