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Abdominal Injuries

F Marzona, N Parri, A Nocerino, M Giacalone, E Valentini, S Masi, L Bussolin
PURPOSE: Traumatic diaphragm rupture (TDR) is a rare complication of trauma in pediatric age and may be easily missed by the severity of associated injuries so that delayed emergent presentation can occur with increased rate of morbidity and mortality. No review has been available to guide clinicians through the pitfalls and the initial diagnostic approach to pediatric TDR. METHODS: A Medline thorough search on TDR was conducted using different queries. English language citations were identified during the period of January 2000 through December 2014 limiting the search to pediatric age (0-18 years)...
October 21, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Jevon R Puckett, John W Pickering, Suetonia C Palmer, John L McCall, Michal T Kluger, Janak De Zoysa, Zoltan H Endre, Mattias Soop
OBJECTIVE: To determine whether a low perioperative minimum urine output target is safe and fluid sparing when compared with the standard target. BACKGROUND: A minimum hourly urine output of 0.5 mL/kg is a key target guiding perioperative fluid therapy. Few data support this standard practice, which may contribute to perioperative fluid overloading. METHODS: We randomized patients without significant risk factors for acute kidney injury undergoing elective colectomy to a minimum urine output target of 0...
October 19, 2016: Annals of Surgery
J C Menon, J K Joseph, M P Jose, B L Dhananjaya, O V Oommen
INTRODUCTION: Snakebite is an occupational hazard causing considerable morbidity and mortality worldwide, particularly so in tropical countries like India. OBJECTIVE: The aim of this study is to (i) review the demographic, clinical and laboratory findings in patients (1051) admitted with venomous snakebite (ii) to correlate mortality, morbidity and duration of hospital stay with clinical signs, symptoms and laboratory parameters. METHODS: A retrospective study of 1051 patients treated for snakebite over 10 years (2000 - 2009) in Little Flower Hospital, Angamaly, Kerala...
August 2016: Journal of the Association of Physicians of India
P Michel, D Wähnert, M Freistühler, M G Laukoetter, S Rehberg, M J Raschke, P Garcia
BACKGROUND: Secondary abdominal compartment syndrome is well known as a life-threatening complication in critically ill patients in an intensive care unit. Massive crystalloid fluid resuscitation has been identified as the most important risk factor. The time interval from hospital admittance to the development of manifest abdominal compartment syndrome is usually greater than 24 hours. In the absence of any direct abdominal trauma, we observed a rapidly evolving secondary abdominal compartment syndrome shortly after hospital admittance associated with massive transfusion of blood products and only moderate crystalloid resuscitation...
October 19, 2016: Journal of Medical Case Reports
Anand Kaul, Sunil Manjila, Jonathan P Miller
: Isadore Max Tarlov (1905-1977) is primarily remembered for his 1938 description of the eponymous perineural "Tarlov cyst." However, during his long career as a neurosurgeon and researcher, he was responsible for many other observations and inventions that influenced the development of neurosurgery in the 20th century. While studying at Johns Hopkins Medical School he was acquainted with Walter Dandy, and he became the first resident to study under Wilder Penfield at the newly formed Montreal Neurological Institute...
November 2016: Neurosurgery
Homero Rivas, Ignacio Robles, Francisco Riquelme, Marcelo Vivanco, Julio Jiménez, Boris Marinkovic, Mario Uribe
OBJECTIVE: To evaluate a new magnetic surgical system during reduced-port laparoscopic cholecystectomy in a prospective, multicenter clinical trial. BACKGROUND: Laparoscopic instrumentation coupled by magnetic fields may enhance surgeon performance by allowing for shaft-less retraction and mobilization. The movements can be performed under direct visualization, generating different angles of traction and reducing the number of trocars to perform the procedure. This may reduce well-known associated complications of trocars, including incisional pain, scarring, infection, bowel, and vascular injuries, among others...
October 17, 2016: Annals of Surgery
Rouhollah Zaboli, Shahram Tofighi, Ali Aghighi, Seyyed Javad Hosaini Shokouh, Nader Naraghi, Hassan Goodarzi
INTRODUCTION: Clinical practice guidelines are structured recommendations that help physicians and patients to make proper decisions when dealing with a specific clinical condition. Because blunt abdominal trauma causes a various range of mild, single-system, and multisystem injuries, early detection will help to reduce mortality and resulting disability. Emergency treatment should be initiated based on CPGs. This study aimed to determine the variables affecting implementing blunt abdominal trauma CPGs in an Iranian hospital...
August 2016: Electronic Physician
Adam Carl Philipoff, William Lumsdaine, Dieter G Weber
Isolated gallbladder rupture following blunt thoracoabdominal trauma is rare; gall bladder rupture is seen in <1% of blunt abdominal trauma. This case report describes a significant mechanism of blunt force injury resulting in an isolated gallbladder rupture. Risk factors for traumatic gallbladder rupture are reviewed and the authors propose that a stiff, cirrhotic liver may exacerbate shear forces in the gallbladder fossa and represents an important risk factor for blunt gallbladder injury. Cholecystectomy remains the definitive management for gallbladder trauma...
October 18, 2016: BMJ Case Reports
Metin Ercan, Mehmet Aziret, Kerem Karaman, Birol Bostancı, Musa Akoğlu
INTRODUCTION: Diaphragmatic hernia secondary to traumatic rupture is a rare entity which can occur after stab wound injuries or blunt abdominal traumas. We aimed to report successfully management of dual mesh repair for a large diaphragmatic defect. CASE REPORT: A 66-year-old male was admitted with a right sided diaphragmatic hernia which occurred ten years ago due to a traffic accident. He had abdominal pain with worsened breath. Chest X-ray showed an elevated right diaphragm...
October 11, 2016: International Journal of Surgery Case Reports
Robert P Olympia, Robert Wilkinson, Jennifer Dunnick, Brendan J Dougherty, Debra Zauner
OBJECTIVE: The aims of this study were to describe pediatric emergency department (ED) referrals from urgent care centers and to determine the percentage of referrals considered essential and serious. METHODS: A prospective study was conducted between April 2013 and April 2015 on patients younger than 21 years referred directly to an ED in central Pennsylvania from surrounding urgent care centers. Referrals were considered essential or serious based on investigations/procedures performed or medications/consultations received in the ED...
October 8, 2016: Pediatric Emergency Care
Hayaki Uchino, Akira Kuriyama, John Bruce, Grant Laing, Damian Clarke, George Oosthuizen
Dog bites are a major cause of injury, especially in the pediatric population. Common anatomic sites of dog bites on children are the peripheries and the head and neck. The torso is reportedly injured less frequently, and only 2 cases of intra-abdominal injury secondary to dog bites have been reported. We recently encountered a 3-year-old boy presenting with peritonitis who had sustained multiple dog bites to his trunk and upper limbs. Emergency laparotomy was performed. Surgical findings revealed penetration of the peritoneum and single perforation of the anterior gastric wall with multiple tooth marks; thus, the gastric perforation was debrided and repaired...
September 30, 2016: Pediatric Emergency Care
Ong-Art Phruetthiphat, Michael Willey, Matthew D Karam, Yubo Gao, Brian O Westerlind, J Lawrence Marsh
OBJECTIVE: To compare patients with acetabular fractures that are isolated (acetabular fracture alone) and acetabular fracture presenting with additional non-acetabular injury using functional outcomes, complications, and readmissions. DESIGN: Retrospective review SETTING:: Level 1 Trauma CenterPatients/Participants: 215 patients underwent open surgical treatment for acetabular fracture between 2003 and 2012 with age ≥18 years and minimum one year follow-up inclusive of functional scores and complications...
October 5, 2016: Journal of Orthopaedic Trauma
Weifeng Luo, Christy M Guth, Olukemi Jolayemi, Craig L Duvall, Colleen Marie Brophy, Joyce Cheung-Flynn
Vascular stretch injury is associated with blunt trauma, vascular surgical procedures, and harvest of human saphenous vein for use in vascular bypass grafting. A model of subfailure overstretch in rat abdominal aorta was developed to characterize surgical vascular stretch injury. Longitudinal stretch of rat aorta was characterized ex vivo. Stretch to the haptic endpoint, where the tissues would no longer lengthen, occurred at twice the resting length. The stress produced at this length was greater than physiologic mechanical forces but well below the level of mechanical disruption...
2016: Frontiers in Bioengineering and Biotechnology
Antoinette S Birs, Jose A Perez, Mark A Rich, Hubert S Swana
Iatrogenic bladder injuries have been reported in the neonate during umbilical artery/vein catheterization, voiding cystourethrogram, urinary catheterizations, and overwhelming hypoxic conditions. Patients with iatrogenic bladder perforations can present with acute abdomen indicating urinary peritonitis, septic-uremic shock, or subtle symptoms like abdominal distension, pain, hematuria, uremia, electrolyte imbalances, and/or difficulty urinating. The following neonatal case report of perforated bladder includes a review of the signs, symptoms, diagnostic tools, and management of bladder injury in neonates...
2016: Case Reports in Urology
Kevin Kalisz, Vasant Garg, Kyle Basques, Robert Gilkeson, Peter Young
RATIONALE AND OBJECTIVES: This study aimed to assess the quality of and analyze trends among clinical indications received for emergency room radiograph studies. MATERIALS AND METHODS: Clinical indications provided by the emergency room and rapid care for consecutive chest, abdominal, and musculoskeletal radiographs were reviewed. Chart review was performed to analyze the provided indications compared to clinical information known to the ordering providers. Chest and abdominal radiograph indications were graded according to symptoms and physical examination signs and relevant past medical history...
October 10, 2016: Academic Radiology
Olubode A Olufajo, Gally Reznor, Stuart R Lipsitz, Zara R Cooper, Adil H Haider, Ali Salim, Erika L Rangel
BACKGROUND: The risk of mortality after emergency general surgery (EGS) in elderly patients is prolonged beyond initial hospitalization. Our objective was to develop a preoperative scoring tool to quantify risk of 1-year mortality. METHODS: Three hundred ninety EGS patients aged 70 years or more were analyzed. Risk factors for 1-year mortality were identified using stepwise-forward logistic multivariate regression and weights assigned using natural logarithm of odds ratios...
September 3, 2016: American Journal of Surgery
G D L Jorge, R R Tártaro, C A F Escanhoela, I D F S F Boin
BACKGROUND: Biliary complications are important causes of morbidity and mortality in patients undergoing hepatic surgery. The aim of the study was to evaluate late liver alterations after a long period of choledochal clamping in Wistar rats. METHODS: Ten male Wistar rats, weighing 304 grams, anesthetized with sodium thiopental (25 mg/kg) and xylazine (10 mg/kg) intravenously, were distributed into 2 groups: the choledochal clamping group (CCG) and the operation sham group (OSG), with 5 animals each submitted to an abdominal incision...
September 2016: Transplantation Proceedings
Ji Hee Kim, Su Kyung Lee, Min Cheol Joo
Objective. To investigate the effects and safety of the aqueous extract of the dried, immature fruit of Poncirus trifoliata (L.) Raf., known as Poncirus fructus (PF), in spinal cord injury (SCI) patients with neurogenic bowel. Methods. Thirty-one SCI patients with neurogenic bowel were recruited. Patients were evaluated based on clinical information, constipation score, Bristol Stool Form Scale, stool retention score using plain abdominal radiograph, and colon transit time. PF was administered in dosages of 800 mg each prior to breakfast and lunch for 14 days...
2016: Evidence-based Complementary and Alternative Medicine: ECAM
Yader Sandoval, Marina Zakharova, Thomas S Rector, Emmanouil S Brilakis, Todd Drexel, Edward O McFalls, Santiago Garcia
The utility of measuring cardiac troponins (cTn) in asymptomatic patients during the perioperative period has been controversial. In the present substudy of the Cardiac Remote Ischemic Preconditioning Prior to Elective Vascular Surgery Trial (NCT01558596), we hypothesized that surveillance of myocardial injury with cTnI in the perioperative period would lead to initiation or intensification of medical therapies for coronary artery disease. Increases in cTnI ≥0.01 μg/l in the perioperative period were considered clinically significant...
September 15, 2016: American Journal of Cardiology
Marije Smit, Maureen J M Werner, Annemieke Oude Lansink-Hartgring, Willem Dieperink, Jan G Zijlstra, Matijs van Meurs
BACKGROUND: Intra-abdominal hypertension (IAH) is frequently present in critically ill patients and is an independent predictor for mortality. Better recognition of clinically important thresholds is necessary. Increased intra-abdominal pressure (IAP) is associated with renal dysfunction, and renal failure is one of the most consistently described organ dysfunctions associated with IAH. Obesity is also associated with kidney injury. The underlying mechanisms are not yet fully understood...
December 2016: Annals of Intensive Care
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