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hepatic trauma

Madhusudan Upadya, Sumesh T Rao
Hypertensive disorders of pregnancy (HDP) remain among the most significant and intriguing unsolved problems in obstetrics. In India, the prevalence of HDP was 7.8% with pre-eclampsia in 5.4% of the study population. The anaesthetic problems in HDP may be due to the effects on the cardiovascular, respiratory, neurologic, renal, haematologic, hepatic and uteroplacental systems. The basic management objectives should be facilitating the birth of an infant who subsequently thrives and completes restoration of health to the mother, or the termination of pregnancy with the least possible trauma to mother and foetus in severe pre-eclampsia...
September 2018: Indian Journal of Anaesthesia
Richard H Kallet, Kelly Ho, Michael S Lipnick, Michael A Matthay
Background: Common causes of acute respiratory distress syndrome (ARDS) include pneumonia, aspiration, non-pulmonary sepsis and trauma. Little is known about pulmonary mechanics and gas exchange in less-common etiologies of ARDS, which comprises 12-23% of cases. Our hospital's ARDS quality assurance database contained a substantial number of these cases. This descriptive study examines the pulmonary mechanics, and gas exchange characteristics of this diverse cohort of ARDS subjects. Methods: Between March 2010 and April 2017 we identified 94 subjects with less common etiologies of ARDS who had dead space fraction (VD /VT ) and respiratory system compliance (CRS ) measured within 24 hours of ARDS onset; 86 of whom did not have sepsis as a co-diagnosis...
August 2018: Journal of Thoracic Disease
Bing Wang, Hua Xu, Jian Li, Hong-Mei Gao, Ying-Hong Xing, Zhu Lin, Hong-Jie Li, Yong-Qiang Wang, Shu-Hua Cao
Increasing evidence has demonstrated that complement activation is required for ischemia‑reperfusion injury (IRI)‑induced hepatic damage, and cobra venom factor (CVF) can deplete the complement components. The aim of the current study was to investigate the effect and intrinsic mechanism of CVF pretreatment on IRI‑induced acute hepatic injury in rats. Acute hepatic injury in rats was induced by bone fracture to simulate trauma, followed by hemorrhage for 90 min, and then the rats were resuscitated for a period of 20 min of reperfusion...
September 14, 2018: Molecular Medicine Reports
Tiffany Anne Blackett, Vic R Simpson, Sean Haugland, David J Everest, Clare F Muir, Kenneth C Smith, Aileen C Mill
Between 2007 and 2014, 337 free-living red squirrels ( Sciurus vulgaris ) on Jersey, Channel Islands, were examined post mortem as part of a mortality and disease surveillance scheme. Road traffic accidents (RTAs) were attributable for 50.7 per cent (171/337) of the casualties, 34.4 per cent (116/337) succumbed to diseases including fatal exudative dermatitis (FED), 7.1 per cent (24/337) to predation, 6.5 per cent (22/337) to other trauma and 1.2 per cent (4/337) to suspected poisoning. Cat predation accounted for 5 per cent (17/337) of mortalities...
September 4, 2018: Veterinary Record
Sumit Kumar, Ronak Modi, Bhavik M Bhandari, David A Sass, Kenneth D Rothstein
INTRODUCTION AND AIM: The evaluation to determine the cause of hepatic encephalopathy consists primarily of laboratory testing to rule out infections and metabolic causes. Despite lack of evidence, it is a common practice amongst clinicians to obtain a head CT as part of their initial evaluation in a cirrhotic presenting with recurrent episodes of hepatic encephalopathy. MATERIAL AND METHODS: Medical records of all cirrhotic adults admitted to a tertiary care hospital from 2007 to 2010 with hepatic encephalopathy were reviewed...
August 24, 2018: Annals of Hepatology
Abouelmagd Makramalla, James Buchino, Jay Johannigman, Ross Ristagno
Venous bullet embolism is a rare complication of trauma. We describe a patient who sustained a gunshot wound. Computed tomography revealed antegrade embolization of the bullet to the right hepatic vein (RHV). The risk of not retrieving the bullet embolus and subsequent embolization to the pulmonary circulation includes pulmonary artery thrombosis, bleeding, or abscess formation. The bullet was retrieved through right internal jugular vein access; assisted by percutaneous transhepatic repositioning and endovascular balloon-immobilization of the bullet...
October 2018: Radiology Case Reports
Lakshmikanth Halegubbi Karegowda, Tadigadapa Keerthi, Taruna Rathore, Kadavigere Rajagopal
No abstract text is available yet for this article.
August 8, 2018: BMJ Case Reports
Jacob Folse, Charles E Hill, Matthew L Graves, George V Russell, Josie Hydrick, LaRita C Jones, William H Replogle, Patrick F Bergin, Clay A Spitler
OBJECTIVES: To evaluate all patients who received gentamicin for open fracture treatment and determine the incidence of, and risk factors for, kidney injury in this population. DESIGN: Retrospective, Case Control SETTING:: Single institution; Level 1 trauma center PATIENTS/PARTICIPANTS:: A retrospective chart review identified patients who received gentamicin for open fracture antibiotic treatment from January 2008-December 2012. Overall, 371 patients met inclusion criteria and were categorized into 2 groups using RIFLE criteria: normal kidney function (74...
July 30, 2018: Journal of Orthopaedic Trauma
Jorge Arturo Cabrera Escamilla, Jorge Álvaro González Ross, José Manuel Pérez Atanasio, Gustavo Casas Martínez, Arelhi González Cisneros, Jose Jimenez Avila
STUDY DESIGN: Retrospective, descriptive case series study. PURPOSE: To investigate the frequency, bone pattern, and associated lesions to the spine of gunshot wounds. OVERVIEW OF LITERATURE: Gunshot wounds are penetrating in nature and are caused by a bullet or projectile. These are becoming more common and are associated with significant sequelae, requiring long and costly multidisciplinary treatment. Associated spinal cord injuries (SCIs) in the civilian population represent 13%-17% of all spinal traumas...
August 2018: Asian Spine Journal
Kiyohiro Oshima, Masato Murata, Makoto Aoki, Jun Nakajima, Yusuke Sawada, Yuta Isshiki, Yumi Ichikawa, Shuichi Hagiwara
Equestrianism is associated with a risk of severe trauma due to falls and/or direct injury from the horse, depending on the mechanism of injury. This article presents four cases of equestrian injury treated in Gunma University Hospital: Case 1: hepatic injury (fall and kick by the horse); Case 2: left hemopneumothorax and pulmonary contusion with multiple rib fractures (fall and trampling by the horse); Case 3: lumbar compression fracture (fall); and Case 4: scrotum injury (horse bite). Equestrian injuries may be high-energy traumas...
2018: Case Reports in Emergency Medicine
Patricia Guzman Rojas, Jignesh Parikh, Anton Mahne, Priya Vishnubhotla, Juan J Oharriz
Hepatic splenosis was first described in 1939 and is a rare condition that results from splenic trauma or splenectomy. A 43-year-old man with a past medical history significant for a prior splenectomy was admitted to the hospital due to right upper quadrant pain for two days. Magnetic resonance imaging (MRI) of the abdomen suggested features of hepatic adenoma, however, a percutaneous biopsy showed the mass within the liver to be a discrete collection of splenic tissue, apparently the result of a traumatic splenic rupture years ago...
May 13, 2018: Curēus
Desiree Raygor, James Cunningham, Joseph Costa, Marie Crandall, David Skarupa
A 69-year-old obese man was involved in a high-speed head-on motor vehicle collision. He was tachycardic and normotensive on arrival. He subsequently developed hemodynamic instability requiring blood transfusion. On examination he had bilateral pneumothoraces, an anterior-posterior compression (APC) pelvic fracture, an open wound at the left groin, and gross hematuria after Foley catheter placement.CT imaging revealed hemoperitoneum, right hepatic lobe grade II lacerations, splenic laceration, mesenteric root injury with extravasated contrast, intraperitoneal and extraperitoneal bladder rupture, bilateral ureteral injuries at the level of the pelvic inlet (see figure 1), APC pelvic fracture, bilateral rib fractures, pneumothoraces, and pulmonary contusions...
2018: Trauma surgery & acute care open
Ying Zhang, Xiangbo An, Qiuyue Lin, Jie Bai, Feng Wang, Jiawei Liao
BACKGROUND: For a long time, our major understanding of the spleen is to function as a blood filter for the removal of aged erythrocytes and circulating microorganisms. Splenectomy, therefore, has been widely performed in case of trauma and a variety of hematologic disorders. Although some studies have indicated an increased rate of developing hyperlipidemia and atherosclerotic cardiovascular diseases in splenectomized patients, our recognition of the splenic regulation on lipid metabolism and atherogenesis is still lacking...
September 2018: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
J Dhaliwal, G B Chavhan, E Lurz, A Shalabi, N Yuen, B Williams, I Martincevic, A Amirabadi, P W Wales, W Lee, S C Ling, M Mouzaki
BACKGROUND: The prevalence of non-alcoholic fatty liver disease (NAFLD) in children is 8% in the general population, and 34% in the context of obesity. There is a paucity of data on the prevalence of hepatic steatosis in healthy children in Ontario. AIMS: To determine the prevalence of hepatic steatosis using abdominal computed tomography (CT) scans in a cohort of previously healthy children across the paediatric age spectrum in Ontario, Canada, and to determine any association between measures of abdominal adiposity and hepatic steatosis...
September 2018: Alimentary Pharmacology & Therapeutics
Timothy T Pham, Grant H Skrepnek, Christopher Bond, Thomas Alfieri, Terry J Cothran, Shellie L Keast
BACKGROUND: Medicaid members are predisposed to unintentional prescription opioid overdose. However, little is known about their individual risk factors. OBJECTIVES: To describe demographic and clinical characteristics, medical utilization, opioid use, concurrent use of benzodiazepines, risk factors, and substances involved in death for Oklahoma's Medicaid members who died of unintentional prescription opioid poisoning. SUBJECTS: Decedents who were Medicaid eligible in Oklahoma during the year of death, had an opioid recorded in cause of death, and had ≥1 opioid prescription claim between January 1, 2011 and June 30, 2016 were cases...
August 2018: Medical Care
Muhammad Asim Rana, Ahmed F Mady, Abdullah Ali Lashari, Rehab Eltreafi, Nicola Fischer-Orr, Kamal Naser
Thrombotic storm (TS) is a rare, acute, hypercoagulable state characterized by multiple thromboembolic events affecting at least two different areas of the vascular system/organs over a short period of time. Typical triggers include inflammation, infections, minor trauma, surgery, pregnancy, and the puerperium. A single thrombotic event can set off a number of thromboembolic events, often including unusual locations like hepatic, portal, or renal veins, skin (purpura fulminans) , adrenal glands, and cerebral sinus venous thrombosis...
2018: Case Reports in Critical Care
Kathleen D Rickert, Pooya Hosseinzadeh, Eric W Edmonds
BACKGROUND: Skeletal trauma is a primary tenet of pediatric orthopaedics. Many high-quality studies have been published over the last few years with substantial relevance to the clinical practice of pediatric orthopaedic trauma. Because of the volume of literature on the subject, this review excludes upper extremity trauma and focuses on the publications affecting the lower extremity. METHODS: An electronic search of the PubMed database was performed utilizing keywords for pediatric lower extremity trauma: pelvic injuries, femur fractures, tibial shaft fractures, femur fractures, ankle fractures, and foot fractures...
September 2018: Journal of Pediatric Orthopedics
Ricardo Quarrie, Stanislaw P Stawicki
Key points: (a) The lifetime risk of portal vein thrombosis (PVT) is approximately 1%; (b) The portal vein is formed by the union of the splenic and superior mesenteric veins posterior to the pancreas; (c) Imaging modalities most frequently used to diagnose PVT include sonography, computed tomography, and magnetic resonance imaging; (d) Malignancy, hepatic cirrhosis, surgical trauma, and hypercoagulable conditions are the most common risk factors for the development of PVT; (e) PVT eventually leads to the formation of numerous collateral vessels around the thrombosed portal vein; (f) First-line treatment for PVT is therapeutic anticoagulation-it helps prevent the progression of the thrombotic process; (g) Other therapeutic options include surgery and interventional radiographic procedures including mechanical thrombectomy and thrombolysis; (h) Portal biliopathy is a clinicopathologic entity characterized by biliary abnormalities due to portal hypertension secondary to PVT and appears to be more common in cases of extrahepatic PVT...
April 2018: International Journal of Critical Illness and Injury Science
Piotr Filip Czempik, Łukasz J Krzych
AHA is an extremely rare disorder, with annual incidence of 1.5 cases per million population. This clinical entity is caused by autoantibodies directed against coagulation factor VIII, what leads to decreased serum activity of thereof, and is characterized by spontaneous or induced by trauma, or invasive procedure bleeding. Approximately 50% of cases are idiopathic in origin, affecting both sexes, with median age at diagnosis of 74 years. We present a case report of a patient diagnosed with acquired haemophilia A (AHA) in the perioperative period...
2018: Anaesthesiology Intensive Therapy
M S Patel, V Shetty, A Shelake, A A Deshpande
Visceral artery aneurysms (VAA) are an uncommon but well recognized condition. Hepatic artery aneurysms (HAA) represent 14-20% of all visceral artery aneurysms. Post traumatic hepatic artery pseudoaneurysm is an uncommon delayed complication of blunt liver trauma. Here we present a case of a 27 year old male with blunt abdominal trauma who developed a post traumatic pseudoaneurysm of the hepatic artery just proximal to its bifurcation into the left and right branches. The pseudoaneurysm ruptured within 12 hours of injury and he required double ligation of the hepatic artery as well as right and left hepatic arteries ...
June 25, 2018: Journal of Postgraduate Medicine
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