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Spleen trauma

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https://www.readbyqxmd.com/read/29040205/spleen-preserving-distal-pancreatectomy-in-trauma
#1
Morgan Schellenberg, Kenji Inaba, Vincent Cheng, James M Bardes, Lydia Lam, Elizabeth Benjamin, Kazuhide Matsushima, Demetrios Demetriades
BACKGROUND: Traumatic injuries to the distal pancreas are infrequent. Universally accepted recommendations about the need for routine splenectomy with distal pancreatectomy do not exist. The aims of this study were to compare outcomes after distal pancreatectomy and splenectomy vs spleen-preserving distal pancreatectomy, and to define the appropriate patient population for splenic preservation. METHODS: All patients who underwent distal pancreatectomy (01/01/2007-12/31/2014) were identified from the NTDB...
October 16, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28993671/mdscs-are-induced-after-experimental-blunt-chest-trauma-and-subsequently-alter-antigen-specific-t-cell-responses
#2
Yvonne Hüsecken, Sylvia Muche, Monika Kustermann, Malena Klingspor, Annette Palmer, Sonja Braumüller, Markus Huber-Lang, Klaus-Michael Debatin, Gudrun Strauss
Severe blunt chest trauma (TxT) induces a strong inflammatory response with posttraumatic immune suppression pointing to an impaired adaptive immune response. Since CD11b(+)Gr-1(+)-expressing myeloid-derived suppressor cells (MDSCs) are induced after inflammation and suppress T cell responses, MDSC induction and their impact on T cell functions was analysed in an experimental TxT model. MDSCs were induced preferentially in the lung until 24 hours after TxT. Although MDSC numbers were only faintly increased in the spleen, splenic MDSCs isolated after TxT strongly inhibited alloantigen-induced T cell proliferation in vitro...
October 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28984337/primary-splenic-pregnancy-a-rare-but-imperative-cause-of-hemoperitoneum-case-report-and-review-of-literature
#3
Ruchi Rathore, Shilpi Shilpi, Ratna Chopra, Namrata Nargotra
Primary splenic pregnancy is an extremely rare form of extratubal ectopic pregnancy. These cases often cause splenic rupture in very early course of their gestation thereby presenting with hemoperitoneum in emergencies. Owing to the higher risk of exsanguination and death caused by hemoperitoneum, it is essential to diagnose these cases for proper management and better prognosis of the patients. We present the case of a 23-year-old female, gravida 2, para 1, live issue 1 presenting to the emergency outpatient department with acute abdomen and hemoperitoneum...
October 6, 2017: Türk Patoloji Dergisi
https://www.readbyqxmd.com/read/28982020/streptococcus-phocae-in-marine-mammals-of-northeastern-pacific-and-arctic-canada-a-retrospective-analysis-of-85-postmortem-investigations
#4
Nicole D Taurisano, Brian P Butler, Diana Stone, Harry Hariharan, Paul J Fields, Hugh W Ferguson, Martin Haulena, Paul Cotrell, Ole Nielsen, Stephen Raverty
Streptococcus phocae is a pathogen of marine mammals, although its pathogenicity remains poorly understood. Recovery of this bacterium from asymptomatic carriers suggests that it is an opportunistic pathogen. We investigated the role of S. phocae in naturally occurring disease and its significance as a pathogen based on postmortem investigations. Between 2007 and 2012, 1,696 whole carcasses, tissue samples, or both were submitted from the northeastern Pacific and Arctic Canada for diagnostic testing. Streptococcus phocae was cultured from phocids (n=66), otariids (n=12), harbor porpoises (Phocoena phocoena; n=5), and sea otters (Enhydra lutris; n=2)...
October 5, 2017: Journal of Wildlife Diseases
https://www.readbyqxmd.com/read/28942415/confusion-and-abdominal-symptoms-following-a-rugby-tackle
#5
Demetris Ioannides, Madeleine Davies, Stefan Kluzek
A 19-year-old man was sent to the emergency department following a pitch-side assessment for suspected concussion, unexplained upper abdominal tenderness and vomiting, following a high-impact tackle during a rugby match. A Focussed Assessment with Sonography for Trauma (FAST) scan performed in the emergency department suggested intra-abdominal free fluid, and subsequent head and abdominal CT imaging showed no intracranial lesion but confirmed a significant haemoperitoneum due to large splenic tear and bleeding...
September 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28941929/minimizing-variance-in-care-of-pediatric-blunt-solid-organ-injury-through-utilization-of-a-hemodynamic-driven-protocol-a-multi-institution-study
#6
Aaron J Cunningham, Katrine M Lofberg, Sanjay Krishnaswami, Marilyn W Butler, Kenneth S Azarow, Nicholas A Hamilton, Elizabeth A Fialkowski, Pamela Bilyeu, Erika Ohm, Erin C Burns, Margo Hendrickson, Preetha Krishnan, Cynthia Gingalewski, Mubeen A Jafri
BACKGROUND: An expedited recovery protocol for management of pediatric blunt solid organ injury (spleen, liver, and kidney) was instituted across two Level 1 Trauma Centers, managed by nine pediatric surgeons within three hospital systems. METHODS: Data were collected for 18months on consecutive patients after protocol implementation. Patient demographics (including grade of injury), surgeon compliance, National Surgical Quality Improvement Program (NSQIP) complications, direct hospital cost, length of stay, time in the ICU, phlebotomy, and re-admission were compared to an 18-month control period immediately preceding study initiation...
September 4, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28932700/endovascular-management-of-arterial-injuries-after-blunt-or-iatrogenic-renal-trauma
#7
REVIEW
Romaric Loffroy, Olivier Chevallier, Sophie Gehin, Marco Midulla, Pierre-Emmanuel Berthod, Christophe Galland, Pascale Briche, Céline Duperron, Nabil Majbri, Christiane Mousson, Nicolas Falvo
The kidney is the third most common abdominal organ to be injured in trauma, following the spleen and liver, respectively. The most commonly used classification scheme is the American Association for the Surgery of Trauma (AAST) classification of blunt renal injuries, which grades renal injury according to the size of laceration and its proximity to the renal hilum. Arteriovenous fistula and pseudoaneurysm are the most common iatrogenic biopsy-related or surgery-related vascular injuries in native kidneys. The approach to renal artery injuries has changed over time from more aggressive intervention to more conservative observational or endovascular management, including selective transcatheter arterial embolization (TAE) and the placement of stents/stent grafts...
August 2017: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28928924/giant-pulmonary-teratoma-with-huge-splenic-lymphangiomatosis-a-very-rare-case
#8
Hemail M Alsubaie, Khaled M Alsubaie, Mohammed Eid Mahfouz
Teratomas are tumors composed of tissues derived from more than one germ cell line. They manifested with a great variety of clinical and radiological features. We report a case of a giant left hemithorax teratoma in a female with huge spleen tumor and review the relevant literature. A 38-year-old female with progressively aggravating dyspnea at rest from a mild trauma. Absent breath sounds on the left side. There was splenomegaly. Computed tomography scan revealed a huge mass (20 × 15 × 18 cm), containing elements of heterogeneous density in the left hemithorax...
September 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28901960/sudden-death-in-an-adult-due-to-nontraumatic-diaphragmatic-hernia
#9
Hideaki Kato, Yasuhiro Aoki, Jun Ohtaki, Yoshimi Nakamura, Mohammed Hassan Gaballah, Mamiko Fukuta, Katsumasa Kobayashi
Sudden death due to diaphragmatic hernia in an adult is exceptionally rare. A 43-year-old man was found dead by his cohabiting mother, lying supine on the floor in his house. He had complained of epigastric discomfort for 1 month, and respiratory symptoms occurred 1 day before his death. He had no history of trauma. Postmortem computed tomography scan revealed the enlarged fluid-filled stomach herniated into the left pleural cavity, compressing the left lung with a mediastinal shift to the right. At autopsy, the left pleural cavity was occupied by herniated abdominal contents with mediastinal shift...
September 9, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28898314/-associated-factors-to-non-operative-management-failure-of-hepatic-and-splenic-lesions-secondary-to-blunt-abdominal-trauma-in-children
#10
Adriana Echavarria Medina, Carlos Hernando Morales Uribe, Luis Guillermo Echavarria R, Viviana María Vélez Marín, Jorge Alberto Martínez Montoya, David Fernando Aguillón
INTRODUCTION: The non operative management (NOM) is the standard management of splenic and liver blunt trauma in pediatric patients.Hemodynamic instability and massive transfusions have been identified as management failures. Few studies evaluate whether there exist factors allowing anticipation of these events. The objective was to identify factors associated with the failure of NOM in splenic and liver injuries for blunt abdominal trauma. PATIENTS AND METHOD: Retrospective analysis between 2007-2015 of patients admitted to the pediatric surgery at University Hospital Saint Vincent Foundation with liver trauma and/or closed Spleen...
2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28871350/-approach-to-liver-spleen-and-pancreatic-injuries-including-damage-control-surgery-of-terrorist-attacks
#11
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/28855777/characteristics-and-management-of-blunt-renal-injury-in-children
#12
Yuichi Ishida, Alan H Tyroch, Nader Emami, Susan F McLean
BACKGROUND: Renal trauma in the pediatric population is predominately due to blunt mechanism of injury. Our purpose was to determine the associated injuries, features, incidence, management, and outcomes of kidney injuries resulting from blunt trauma in the pediatric population in a single level I trauma center. METHODS: This was a retrospective chart and trauma registry review of all pediatric blunt renal injuries at a regional level I trauma center that provides care to injured adults and children...
July 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28844961/mitochondrial-dysfunction-in-rat-splenocytes-following-hemorrhagic-shock
#13
Marie Warren, Kumar Subramani, Richard Schwartz, Raghavan Raju
The regulation of mitochondrial function is critical in cellular homeostasis following hemorrhagic shock. Hemorrhagic shock results in fluid loss and reduced availability of oxygen and nutrients to tissues. The spleen is a secondary lymphoid organ playing a key role in 'filtering the blood' and in the innate and adaptive immune responses. To understand the molecular basis of hemorrhagic shock, we investigated the changes in splenocyte mitochondrial respiration, and concomitant immune and metabolic alterations...
August 26, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28843717/variables-associated-with-pulmonary-thromboembolism-in-injured-patients-a-systematic-review
#14
Ryan Shuster, Joseph Mathew, Alexander Olaussen, Dashiell Gantner, Dinesh Varma, Jim Koukounaras, Mark C Fitzgerald, Peter A Cameron, Biswadev Mitra
BACKGROUND: Pulmonary thromboembolism (PTE) is a dangerous complication of traumatic injury, with varied risk profiles and treatment options. This review aims to describe reported incidence and variables associated with PTE among severely injured patients. METHODS: Searches were conducted using PubMed, Cochrane and MEDLINE. Relevant studies were identified by two independent reviewers based on predetermined inclusion criteria. Incidence of PTE was the primary outcome measure...
August 18, 2017: Injury
https://www.readbyqxmd.com/read/28832081/primary-splenic-pregnancy-a-rare-but-imperative-cause-of-hemoperitoneum-case-report-and-review-of-literature
#15
Ruchi Rathore, Shilpi Shilpi, Ratna Chopra, Namrata Nargotra
Primary splenic pregnancy is an extremely rare form of extratubal ectopic pregnancy. These cases often cause splenic rupture in very early course of their gestation thereby presenting with hemoperitoneum in emergencies. Owing to the higher risk of exsanguination and death caused by hemoperitoneum, it is essential to diagnose these cases for proper management and better prognosis of the patients. We present the case of a 23-year-old female, gravida 2, para 1, live issue 1 presenting to the emergency outpatient department with acute abdomen and hemoperitoneum...
2017: Türk Patoloji Dergisi
https://www.readbyqxmd.com/read/28830124/postmortem-fluid-and-tissue-concentrations-of-thc-11-oh-thc-and-thc-cooh
#16
Sunday R Saenz, Russell J Lewis, Mike K Angier, Jarrad R Wagner
Marijuana is the most commonly abused illicit drug worldwide. Marijuana is used for its euphoric and relaxing properties. However, marijuana use has been shown to result in impaired memory, cognitive skills and psychomotor function. The Federal Aviation Administration's Civil Aerospace Medical Institute conducts toxicological analysis on aviation fatalities. Due to severe trauma associated with aviation accidents, blood is not always available; therefore, the laboratory must rely on specimens other than blood for toxicological analysis in ~30-40% of cases...
July 1, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/28828034/splenic-trauma-wses-classification-and-guidelines-for-adult-and-pediatric-patients
#17
REVIEW
Federico Coccolini, Giulia Montori, Fausto Catena, Yoram Kluger, Walter Biffl, Ernest E Moore, Viktor Reva, Camilla Bing, Miklosh Bala, Paola Fugazzola, Hany Bahouth, Ingo Marzi, George Velmahos, Rao Ivatury, Kjetil Soreide, Tal Horer, Richard Ten Broek, Bruno M Pereira, Gustavo P Fraga, Kenji Inaba, Joseph Kashuk, Neil Parry, Peter T Masiakos, Konstantinos S Mylonas, Andrew Kirkpatrick, Fikri Abu-Zidan, Carlos Augusto Gomes, Simone Vasilij Benatti, Noel Naidoo, Francesco Salvetti, Stefano Maccatrozzo, Vanni Agnoletti, Emiliano Gamberini, Leonardo Solaini, Antonio Costanzo, Andrea Celotti, Matteo Tomasoni, Vladimir Khokha, Catherine Arvieux, Lena Napolitano, Lauri Handolin, Michele Pisano, Stefano Magnone, David A Spain, Marc de Moya, Kimberly A Davis, Nicola De Angelis, Ari Leppaniemi, Paula Ferrada, Rifat Latifi, David Costa Navarro, Yashuiro Otomo, Raul Coimbra, Ronald V Maier, Frederick Moore, Sandro Rizoli, Boris Sakakushev, Joseph M Galante, Osvaldo Chiara, Stefania Cimbanassi, Alain Chichom Mefire, Dieter Weber, Marco Ceresoli, Andrew B Peitzman, Liban Wehlie, Massimo Sartelli, Salomone Di Saverio, Luca Ansaloni
Spleen injuries are among the most frequent trauma-related injuries. At present, they are classified according to the anatomy of the injury. The optimal treatment strategy, however, should keep into consideration the hemodynamic status, the anatomic derangement, and the associated injuries. The management of splenic trauma patients aims to restore the homeostasis and the normal physiopathology especially considering the modern tools for bleeding management. Thus, the management of splenic trauma should be ultimately multidisciplinary and based on the physiology of the patient, the anatomy of the injury, and the associated lesions...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28814248/pediatric-abdominal-trauma
#18
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/28790101/splenic-rupture-following-synchronised-direct-current-cardioversion
#19
Nicholas Kaufman, David Ferraro
Atraumatic rupture of the normal spleen is a rare entity. Often, a triggering factor or minor physical event can be ascribed as the aetiology for rupture, including coughing, vomiting or minor medical procedures not involving the spleen. A 65-year-old man who was hospitalised for eosinophilic pneumonia developed haemodynamically unstable atrial flutter that necessitated urgent synchronised direct current cardioversion (DCCV). Two hours after successful cardioversion, he developed signs of an acute abdomen with free intraperitoneal fluid identified on bedside ultrasonography...
August 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28779968/evolution-of-the-treatment-of-splenic-injuries-from-surgery-to-non-operative-management
#20
Patrizio Petrone, María Fernanda Anduaga Peña, María José Servide Staffolani, Collin Brathwaite, Alexander Axelrad, José Ceballos Esparragón
The spleen is one of the most frequently injured organs in blunt abdominal trauma. In the past decades, the treatment of patients with blunt splenic injury has shifted from operative to non-operative management. The knowledge of physiology and immunology of the spleen have been the main reasons to develop techniques for splenic salvage. The advances in high-resolution imaging techniques, as well as less invasive procedures, including angiography and angioembolization, have allowed a higher rate of success in the non-operative management...
August 2, 2017: Cirugía Española
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