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Abdominal Injuries

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https://www.readbyqxmd.com/read/28634629/medical-malpractice-claims-in-laparoscopic-gynecologic-surgery-a-dutch-overview-of-20-years
#1
Evelien M Sandberg, Esmée M Bordewijk, Désirée Klemann, Sara R C Driessen, Andries R H Twijnstra, Frank Willem Jansen
BACKGROUND: The success of newly introduced surgical techniques is generally primarily assessed by surgical outcome measures. However, data on medical liability should concomitantly be used to evaluate provided care as they give a unique insight into substandard care from patient's point of view. The aim of this study was to analyze the number and type of medical claims after laparoscopic gynecologic procedures since the introduction of advanced laparoscopy two decades ago. Secondly, our objective was to identify trends and/or risk factors associated with these claims...
June 20, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28632657/role-of-computed-tomography-in-the-classification-of-pediatric-pelvic-fractures-revisited
#2
Melissa A Bent, William L Hennrikus, Johan E Latorre, Douglas G Armstrong, Brian Shaw, Kerwyn C Jones, Lee S Segal
OBJECTIVES: To determine the need for computerized tomography (CT) scans in the assessment of pediatric pelvic fractures. DESIGN: Retrospective Chart Review. SETTING: Level-1 Pediatric Trauma Center. PATIENTS/PARTICIPANTS: Thirty pediatric trauma patients with pelvic fractures who have obtained both a radiograph and CT scan. MAIN OUTCOME MEASUREMENTS: Fleiss Kappa coefficient to compare interreliability...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28632534/administration-of-tetrahydrobiopterin-bh4-protects-the-renal-microcirculation-from-ischemia-and-reperfusion-injury
#3
Lokmane Rahmania, Diego Orbegozo, Fuhong Su, Fabio Silvio Taccone, Jean-Louis Vincent, Daniel De Backer
BACKGROUND: Abdominal aortic aneurysm surgery with suprarenal cross-clamping is often associated with renal injury. Although the mechanism underlying such injury is unclear, tissue ischemia and reperfusion, which induces endothelial dysfunction and decreases the availability of tetrahydrobiopterin (BH4), may play a role. We evaluated whether BH4 administration prevents renal ischemia/reperfusion injury in an animal model of aortic cross-clamping. METHODS: Nineteen anesthetized, mechanically ventilated, and invasively monitored adult sheep were randomized into 3 groups: sham animals (n = 5) that underwent surgical preparation but no aortic clamping; an ischemia/reperfusion group (n = 7), where the aorta was clamped above the renal arteries for 1 hour, and a BH4 group (n = 7), in which animals received 20 mg/kg of BH4 followed by aortic cross-clamp for 1 hour...
June 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28630645/the-use-of-laparoscopy-in-managing-penetrating-thoracoabdominal-injuries-in-africa-83-cases-reviewed
#4
Zach M Koto, Fusi Mosai, Oleh Y Matsevych
BACKGROUND: The use of laparoscopy in managing haemodynamically stable patients with penetrating thoracoabdominal injuries in developed countries is wildly practiced, but in Africa, the use of laparoscopy is still in its infancy stage. We reviewed a single centre experience in using laparoscopy in Africa for management of patients with both isolated diaphragmatic injuries as well as diaphragmatic injuries associated with intra-abdominal injuries requiring intervention. METHODS: A retrospective analysis of prospectively collected data of patients presenting with penetrating thoracoabdominal injuries was done...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28630239/an-unusual-case-of-escherichia-coli-o157-h7-infection-with-pseudomembranous-colitis-like-lesions-associated-with-haemolytic-uraemic-syndrome-and-neurological-sequelae
#5
James Kennedy, Lauren Simmonds, Robert Orme, Warren Doherty
A 75-year-old man was admitted with abdominal pain and fresh rectal bleeding. Significantly, he had no risk factors for Clostridium difficile infection. An abdominal CT demonstrated colonic thickening, and flexible sigmoidoscopy identified pseudomembranous colitis-like lesions. After initial treatment as C. difficile colitis, a stool sample revealed Escherichia coli O157:H7 infection. Antibiotic therapy was stopped due to the risk of lysis-mediated toxin release, but unfortunately, the patient continued to deteriorate...
June 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28629766/laparoscopic-assisted-approach-for-penetrating-abdominal-trauma-a-solution-for-multiple-bowel-injuries
#6
Oleh Yevhenovych Matsevych, Modise Zacharia Koto, Colleen Aldous
BACKGROUND: Therapeutic laparoscopy (TL) for penetrating abdominal trauma (PAT) is controversial because the management of multiple bowel injuries is challenging and the conversion rate is high. However, the laparoscopic-assisted approach (LAA) allows easy management of multiple bowel injuries but not investigated in a trauma setting. The aim of this study was to investigate its role in management of multiple bowel injuries and to compare LAA with therapeutic laparoscopy performed fully laparoscopically (FTL)...
June 16, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28629353/lipid-emulsion-mitigates-impaired-pulmonary-function-induced-by-limb-ischemia-reperfusion-in-rats-through-attenuation-of-local-cellular-injury-and-the-subsequent-systemic-inflammatory
#7
Fangfang Xia, Yun Xia, Sisi Chen, Lulu Chen, Weijuan Zhu, Yuanqing Chen, Thomas J Papadimos, Xuzhong Xu, Le Liu
BACKGROUND: Limb ischemia/reperfusion causes inflammation and elicits oxidative stress that may lead to local tissue damage and remote organ such as lung injury. This study investigates pulmonary function after limb ischemia/reperfusion and the protective effect of a lipid emulsion (Intralipid). METHODS: Twenty-four rats were divided into three groups: sham operation group (group S), ischemia/reperfusion group (group IR), and lipid emulsion treatment group (group LE)...
June 19, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28628674/hepatic-microvascular-dysfunction-and-increased-advanced-glycation-end-products-are-components-of-non-alcoholic-fatty-liver-disease
#8
Evelyn Nunes Goulart da Silva Pereira, Raquel Rangel Silvares, Edgar Eduardo Ilaquita Flores, Karine Lino Rodrigues, Isalira Peroba Ramos, Igor José da Silva, Marcelo Pelajo Machado, Rosiane Aparecida Miranda, Carmen Cabanelas Pazos-Moura, Cassiano F Gonçalves-de-Albuquerque, Hugo Caire de Castro Faria-Neto, Eduardo Tibiriça, Anissa Daliry
BACKGROUND: This study aimed to investigate the pathophysiology of hepatic microcirculatory dysfunction in non-alcoholic fatty liver disease (NAFLD). METHODS: In Wistar rats, NAFLD model was induced by 20 weeks of high-fat diet (HFD) feeding. Rolling and adhesion of leukocytes and tissue perfusion in hepatic microcirculation were examined using in vivo microscopic and laser speckle contrast imaging (LSCI), respectively. Oxidative stress and inflamatory parameters were analysed by TBARs, catalase enzyme activity, RT-PCR and ELISA...
2017: PloS One
https://www.readbyqxmd.com/read/28628603/field-and-en-route-resuscitative-endovascular-occlusion-of-the-aorta-a-feasible-military-reality
#9
Viktor A Reva, Tal M Hörer, Andrey I Makhnovskiy, Mikhail V Sokhranov, Igor M Samokhvalov, Joseph J DuBose
BACKGROUND: Severe noncompressible torso hemorrhage remains a leading cause of potentially preventable death in modern military conflicts. Resuscitative endovascular occlusion of the aorta (REBOA) has demonstrated potential as an effective adjunct to the treatment of noncompressible torso hemorrhage in the civilian early hospital and even prehospital settings-but the application of this technology for military prehospital use has not been well described. We aimed to assess the feasibility of both field and en route prehospital REBOA in the military exercise setting, simulating a modern armed conflict...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28628271/surgical-treatment-of-trans-sphincteric-anal-fistulas-with-the-fat-graft-technique-a-minimally-invasive-procedure
#10
N Stroumza, G Fuzco, J Laporte, R Nail Barthelemy, S Houry, M Atlan
AIM: Anal fistulas are common pathologies with a significant social impact; however their treatment is often complex and the recurrence rate can be significant. Some surgical treatments for fistula are also associated with the risk of sphincter injury. In this technical note, we aim to evaluate the feasibility and efficacy of the Fat GRAFT technique (Fat Grafting in Anal Fistula Treatment) in the treatment of recurrent anal fistulas. METHOD: All patients presenting with recurrent trans-sphincteric anal fistulas over an 18-month period were included...
June 19, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28627341/-protective-effects-of-valproic-acid-on-gut-barrier-function-after-major-burn-injury-and-its-mechanism
#11
Hongmin Luo, Sen Hu, Huining Bian, Shaoyi Zheng, Bing Xiong, Zhifeng Huang, Zuan Liu, Chuanwei Sun, Lianghua Ma, Hanhua Li, Wen Yu, Minghua Du, Huade Chen, Wen Lai
OBJECTIVE: To investigate the potential protective effects of valproic acid (VPA) on gut barrier function after major burn injury in rats and its mechanism. METHODS: Forty male Sprague-Dawley (SD) rats were divided into sham + normal saline (NS), sham + VPA, scald + NS, and scald + VPA groups, with 10 rats in each group. Rat with 55% total body surface area (TBSA) third-degree severe-burns model was reproduced by immersing into 80 °C water, and the rats in sham groups were given sham-burns by immersing into 37 °C water...
March 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28626382/a-symptomatic-coffee-bean-acute-sigmoid-volvulus
#12
Michael Scharl, Luc Biedermann
An acute sigmoid volvulus is due to the torsion of the sigmoid colon around its mesenteric axis. It mainly occurs in elderly patients and represents an abdominal emergency requiring urgent treatment. A 53-year-old male patient with severe craniocerebral injury and traumatic subarachnoidal bleeding 3 weeks prior presented on the ward with distended abdomen without abdominal pain, muscular defense, or resistances. He featured large volume diarrhea within the last few hours without signs of bleeding. A plain abdominal X-ray demonstrated a coffee bean sign indicating a sigmoid volvulus...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28625692/implementation-of-clinical-effectiveness-guidelines-for-solid-organ-injury-after-trauma-10-year-experience-at-a-level-1-pediatric-trauma-center
#13
Christine M Leeper, Isam Nasr, Abigail Koff, Christine McKenna, Barbara A Gaines
BACKGROUND: Diagnostic imaging of pediatric blunt abdominal trauma is evolving in light of increased attention to radiation exposure. We hypothesize that the implementation of imaging guidelines has reduced total CT scans without missing clinically significant injury. METHODS: We retrospectively reviewed blunt trauma patients age 0-17 with solid organ injury who underwent CT scan at our academic level 1 pediatric trauma center between 2005 and 2014. Variables including total annual trauma admissions and CT scans, demographics, injury characteristics, and procedures were recorded...
June 6, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28620570/perforated-bladder-as-a-cause-of-abdominal-ascites-in-a-patient-presenting-with-acute-onset-abdominal-pain
#14
Raj Shah, Madhuri Ramakrishnan, Beenish Ahmed, Khalil Abuamr, Osama Yousef
Bladder perforation, especially when atraumatic, is a rare cause of ascites and is often difficult to differentiate from other causes of abdominal pain and ascites in the acute setting.  A 43-year-old Caucasian woman with a history of multiple sclerosis presented with acute abdominal pain. A computed tomography (CT) scan of her abdomen and pelvis without contrast revealed ascites, acute kidney injury (AKI) was noted on laboratory workup, and very little urine was drained by Foley catheter. Over the next several days, the patient's clinical condition deteriorated with no definitive diagnosis...
May 11, 2017: Curēus
https://www.readbyqxmd.com/read/28619688/single-port-laparoscopy-in-gynecologic-oncology-seven-years-of-experience-at-a-single-institution
#15
Laura Moulton, Amelia M Jernigan, Caitlin Carr, Lindsey Freeman, Pedro F Escobar, Chad M Michener
BACKGROUND: Single port laparoscopy has gained popularity within minimally invasive gynecologic surgery for its feasibility, cosmetic outcomes and safety. However, within gynecologic oncology, there is limited data regarding short-term adverse outcomes and long term hernia risk in patients undergoing single port laparoscopic surgery. OBJECTIVE: To describe short-term outcomes and hernia rates in patients after single port laparoscopy in a gynecologic oncology practice...
June 12, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28619496/injury-to-the-lumbar-plexus-and-its-branches-following-lateral-fusion-procedures-a-cadaver-study
#16
Peter Grunert, Doniel Drazin, Joe Iwanaga, Cameron Schmidt, Fernando Alonso, Marc Moisi, Jens R Chapman, Rod J Oskouian, R Shane Tubbs
INTRODUCTION: Neurological deficits from lumbar plexus nerve injuries commonly occur in patients undergoing lateral approaches. However, it is not yet clear what types of injury occur, where anatomically they are located, or what mechanism causes them. We aimed, to study (a) the topographic anatomy of lumbar plexus nerves and their injuries in human cadavers after lateral transpsoas approaches to the lumbar spine, (b) the structural morphology of those injuries, (c) the topographic anatomy of the lumbar plexus throughout the mediolateral approach corridor...
June 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28616615/the-predictive-value-of-biochemical-parameters-in-evaluating-patients-with-abdominal-trauma-the-new-scoring-system
#17
Ekrem Musalar, Murat Ersel, Funda Karbek Akarca, Güçlü Selahattin Kıyan, Özge Can
AIM: The aim of this study was to investigate the contribution of non-invasively and rapidly obtained biochemical parameter results to the diagnosis and follow-up of intraabdominal injuries in multitrauma patients. MATERIAL AND METHODS: A total of 2604 multitrauma patients who were treated following their referral to our emergency department between January 2009 and January 2012 were retrospectively reviewed. A logistic regression analysis was used in the risk assessment...
June 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28616155/severe-pelvic-fracture-with-profound-hypotension-a-case-report-and-treatment-algorithm
#18
Chadwick J Knight, Igor Wanko Mboumi, Errington C Thompson
Approximately 9% of all blunt trauma patients suffer pelvic fractures. These fractures can range from insignificant and requiring almost no therapy to massive destruction of the pelvic ring with associated with multisystem injury and life-threatening hypotension which mandates the attention of the trauma surgeon, the orthopedic surgeon, the interventional radiologists and possibly other subspecialists. We present a case of a patient who presented to the emergency room in extremis from massive bleeding from a complex pelvic fracture...
June 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28615097/-protective-effect-of-quercetin-against-seawater-instillation-induced-acute-lung-injury-through-preventing-m1-polarization-of-macrophages-in-mice
#19
Baojian Wang, Xu Mao
Objective To study the protective effect of quercetin against seawater instillation-induced acute lung injury (SW-ALI) and explore the roles of M1polarization of macrophages and M1 macrophage-mediated inflammation in the protective effect. Methods Male C57BL/6 mice were randomly divided into four groups, normal control group, quercetin-treated group, SW-ALI group, SW-ALI and quercetin-treated group, with 15 mice in each group. The mice were intraperitoneally injected with 1 g/L pentobarbital sodium, and then seawater was injected into the lungs through oropharyngeal intubation at the concentration of 4 mL/kg...
June 2017: Xi Bao Yu Fen Zi Mian Yi Xue za Zhi, Chinese Journal of Cellular and Molecular Immunology
https://www.readbyqxmd.com/read/28614170/implications-of-left-sided-gallbladder-in-the-emergency-setting-retrospective-review-and-top-tips-for-safe-laparoscopic-cholecystectomy
#20
Hariscine K Abongwa, Belinda De Simone, Laura Alberici, Maurizio Iaria, Gennaro Perrone, Antonio Tarasconi, Gianluca Baiocchi, Nazario Portolani, Salomone Di Saverio, Massimo Sartelli, Federico Coccolini, Jennifer E Manegold, Luca Ansaloni, Fausto Catena
BACKGROUND: Left-sided gallbladder without situs viscerum inversus (LSG-woSVI) is a rare congenital anomaly. Clinical features and routine presurgical imaging could miss the anomalous position, thereby producing complications during surgery. Laparoscopic cholecystectomy can be performed safely, but the risk of bile duct injury (BDI) is greater than in cholecystectomy of the orthotopic gallbladder. We present a retrospective review of all scientific literature for diagnosed cases of LSG-woSVI undergoing cholecystectomy from 1996 to 2014...
June 13, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
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