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Abdomen trauma

Mostafa A Abolfotouh, Mohamed A Hussein, Sameh M Abolfotouh, Alanoud Al-Marzoug, Suliman Al-Teriqi, Abeer Al-Suwailem, Ra'ed A Hijazi
Background: The aim of this study was to describe the pattern of traumatic injuries and determine the predictors of inhospital mortality in patients admitted to the emergency department. Patients and methods: This is a retrospective cohort study of 3,786 patients with traumat injuries admitted to the emergency department of King Abdulaziz Medical City, Riyadh, Saudi Arabia, between January 2012 and December 2014. Data on patient characteristics, trauma characteristics and outcomes were extracted from medical records...
2018: Open Access Emergency Medicine: OAEM
Tomoo Watanabe, Yasuyuki Kawai, Asami Iwamura, Naoki Maegawa, Hidetada Fukushima, Kazuo Okuchi
Traumatic brain injury (TBI) is a leading cause of death and disability in trauma patients. Patients with TBI frequently sustain concomitant injuries in extracranial regions. The effect of severe extracranial injury (SEI) on the outcome of TBI is controversial. For 8 years, we retrospectively enrolled 485 patients with the blunt head injury with head abbreviated injury scale (AIS) ≧ 3. SEI was defined as AIS ≧ 3 injuries in the face, chest, abdomen, and pelvis/extremities. Vital signs and coagulation parameter values were also extracted from the database...
August 11, 2018: Neurologia Medico-chirurgica
Amanda Bader, Uzma Rahman, Matthew Morris, Jane E McCormack, Emily C Huang, Marlene Zawin, James A Vosswinkel, Randeep S Jawa
BACKGROUND: In the general population with blunt chest trauma, pulmonary contusions (PCs) are commonly identified. However, there is limited research in the elderly. We sought to evaluate the incidence and outcomes of PCs in elderly blunt trauma admissions. METHODS: We retrospectively reviewed the trauma registry at a level I trauma center for all blunt thoracic trauma patients aged ≥65 y, who were admitted between 2007 and 2015. The medical records of PC patients were reviewed...
October 2018: Journal of Surgical Research
Ankit Shukla, Varun Verma, Krishan Lal Kapoor, Bhanu Gupta, Rajesh Chaudhry
Blunt trauma abdomen is a very common entity but traumatic abdominal wall hernia is not that common. Herniation through abdominal wall usually occurs following trauma with seat belt, motor cycle, bicycle handle bar etc. Handlebar hernia is a less known variety of traumatic abdominal wall hernia as a consequence of injury with handlebar of a bicycle. It is difficult to diagnose and one should have high index of suspicion. Management in traumatic abdominal wall hernia is individualized based on various factors...
July 2018: Bulletin of Emergency and Trauma
Ali Al Orf, Khawaja Bilal Waheed, Aftab Ahmed Baig, Khaled Saleh Mohammad, Mohamed Nasr El Sirafy, Muhammad Sohail Amin, Zechriah Jebakumar Arulanatham
BACKGROUND: Pan-scan (whole-body) computed tomography (CT) has a paramount role in the diagnosis of injuries in road traffic accidents (RTA). OBJECTIVE: Identify patterns of injuries on pan-CT scans. DESIGN: Retrospective medical record review. SETTING: Tertiary care center. PATIENTS AND METHODS: The records of all RTA patients who presented to the radiology department at King Fahad Military Medical Complex (KFMMC) in Dhahran for the 3-year period from July 2014 to July 2017 and underwent pan-CT were retrospectively reviewed...
July 2018: Annals of Saudi Medicine
Jason F Naylor, Michael D April, Guyon J Hill, Kelley M Kempski, Allyson A Arana, Steven G Schauer
OBJECTIVES: Pediatric casualties made up a significant proportion of patients during the recent military conflicts in Iraq and Afghanistan. Damage control resuscitation strategies used by military physicians included rapid reversal of metabolic acidosis to mitigate its pathophysiologic consequences, primarily through hemorrhage control and volume restoration. Alkalizing agents, including tris(hydroxymethyl)aminomethane (THAM), are potential therapeutic adjuncts to treat significant acidosis...
August 2018: Southern Medical Journal
Anders Peter Skovsen, Jakob Burcharth, Mai-Britt Tolstrup, Ismail Gögenur
Acute abdomen is a common cause of admission to hospital. Emergency laparotomy is associated with a significant morbidity and mortality due to deranged physiology and surgery-induced stress. Damage control laparotomy is on the rise as an operative strategy for the septic abdomen as well as for trauma laparotomy but lacks definition in the non-trauma setting. Principles of perioperative care in elective surgery are currently applied to the emergency abdominal surgery patients and should be further studied in the future to reduce morbidity and mortality...
July 30, 2018: Ugeskrift for Laeger
Kathryn Sommese, Katherine Kelley, Bethany Tan, Mark Fontana, Jared Brooks
Postoperative iatrogenic diaphragmatic hernias have been reported sparingly after several thoracic and abdominal surgeries. Although rare, a delay in diagnosis can lead to life-threatening cases of strangulation or perforation, as well as cardiovascular and respiratory insufficiency. This is a case of a 78-year-old female who developed acute obstructive symptoms secondary to herniation of the distal stomach through a defect in the central tendon of the diaphragm. The diaphragmatic defect was presumed to be iatrogenically acquired after Nissen fundoplication one year prior...
July 1, 2018: American Surgeon
C Danny Darlington, G Fatima Shirly Anitha
Ascariasis is a common worm infestation in developing and under-developed countries. It is caused by the ingestion of food contaminated with Ascaris eggs from faeces and is more common in places with poor sanitation. Almost 25% of the world population is infested by Ascaris lumbricoides. Although ascariasis is a chronic disease, it can present as acute abdomen rarely. The wandering nature of Ascaris in and out of the bowel causes various abdominal complications such as intestinal obstruction, perforation, biliary ascariasis, pancreatic ascariasis, liver abscess, appendicitis, and Meckel's diverticulitis...
July 2018: Iranian Journal of Medical Sciences
Stanislau Makaranka, Pennylouise Hever, Naveen Cavale
Traumatic abdominal wall hernia (TAWH) is a rare type of hernia occurring secondary to blunt trauma. We report a case of seatbelt-associated TAWH in a 20-year-old woman who was presented to hospital via ambulance following a road traffic collision with a distended abdomen, peritonitis and free gas, with an associated TAWH identified on CT imaging. The patient underwent delayed surgical repair of her hernia using biological mesh, without recurrence, with a clinical course complicated by pregnancy. We use this report to demonstrate late repair as a safe and effective option for management of TAWH in pregnancy, with active surveillance and a multidisciplinary approach by the obstetric, plastic surgery and trauma teams...
July 19, 2018: BMJ Case Reports
M O Jakob, C Schwarz, T Haltmeier, J Zindel, T Pinworasarn, D Candinas, P Starlinger, G Beldi
BACKGROUND: Open abdomen (OA) may be required in patients with abdominal trauma, sepsis or compartment syndrome. Vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) is a widely used approach for temporary abdominal closure to close the abdominal wall. However, this method is associated with a high incidence of re-operations in short term and late sequelae such as incisional hernia. The current study aims to compare the results of surgical strategies of OA with versus without permanent mesh augmentation...
July 19, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
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
Nikita Wadhwani, Omesh Kumar Meena, Vivek Verma
Perforation of the gall bladder can occur due to a complication of acute (in 3%-10%) or chronic cholecystitis, presenting with or without gallstones. Other causes include trauma, neoplasms, steroid therapy or vascular compromise. In 1934, Niemeier classified the condition into three types: type I, acute perforation into the free peritoneal cavity; type II, subacute perforation with abscess formation; and type III, chronic perforation with fistula formation between the gall bladder and another viscus with type I experiencing the highest mortality rate...
July 17, 2018: BMJ Case Reports
Hang-Fai So, Hajir Nabi
INTRODUCTION: Handlebar hernias are rare; they result from blunt force impacting the abdomen. This focal blunt trauma causes a tear of the underlying abdominal muscle and fascia without necessarily disrupting the skin. The site of the hernia is usually remote from the site of trauma so clinicians may be falsely reassured if they locally explore the site of bruising. The physical examination of such patient may not obviously suggest such an injury and the diagnosis can be easily missed...
2018: International Journal of Surgery Case Reports
Andreas Brännström, David Rocksén, Johan Hartman, Niklas Nyman, Jenny Gustavsson BSc, Ulf P Arborelius, Mattias Günther
BACKGROUND: Uncontrolled hemorrhage is a leading cause of tactical trauma related deaths. Hemorrhage from the pelvis and junctional regions are particularly difficult to control due to the inability of focal compression. The Abdominal Aortic and Junctional Tourniquet (AAJT) occludes aortic blood flow by compression of the abdomen. The survivability of tourniquet release beyond 120 min is unknown and fluid requirements to maintain sufficient blood pressure during prolonged application are undetermined...
July 5, 2018: Journal of Trauma and Acute Care Surgery
Bradley S Rostad, Kimberly E Applegate, Tammy Kim, Renee M Mansour, Sarah S Milla
BACKGROUND: Many patients at our pediatric hospital have had a contrast-enhanced CT of the abdomen and pelvis performed by an outside imaging facility before admission. We have noticed that many of these exams are multiphase, which may contribute to unnecessary radiation dose. OBJECTIVE: To determine the frequency of multiphase acquisitions and radiation dose indices in contrast-enhanced CTs of the abdomen and pelvis performed by outside imaging facilities in patients who were subsequently transferred to our pediatric hospital for care, and compare these metrics to contrast-enhanced CTs of the abdomen and pelvis performed internally...
July 7, 2018: Pediatric Radiology
Chiharu Kinoshita, Pham Nguyen Quy, Masanori Honda
Splenic hemorrhage is a potentially life-threatening complication usually occurring after blunt trauma to the abdomen. Atraumatic splenic rupture (ASR) is an uncommon condition, and mostly results from pathology affecting the spleen, such as tumor infiltration or infection. Here, we report a case of atraumatic rupture of a normal spleen in a patient undergoing peritoneal dialysis, and review similar cases in the literature. The case involved a 58-year-old man with nephrotic syndrome who had been undergoing peritoneal dialysis for 1 year...
June 29, 2018: CEN Case Reports
L Cruickshank, A Amin, A DeSilva
We present a case of small bowel evisceration occurring as a late complication following vaginal hysterectomy and subsequent vault prolapse. CASE HISTORY: A 92-year-old female presented with sudden onset severe abdominal pain, followed by the sensation of vaginal fullness and the discovery of a large prolapse per vagina, with no history of trauma or sexual intercourse. Past medical history consisted of vaginal hysterectomy 20 years previously with a subsequent sacrospinous vault fixation...
July 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Mehmet Tolga Kafadar, İbrahim Teker, Mehmet Ali Gök, Esat Taylan Uğurlu, İsmail Çetinkaya
Splenic abscess is a very rare condition in the general population. It is more likely to develop in association with underlying comorbidities and trauma. More attention should be paid in patients with immunosuppression, diabetes mellitus, and congenital or acquired immunocompromise. Splenic rupture secondary to nontraumatic abscess causing acute abdomen is a rarer condition. Herein, we report a 55-year-old hemodialysis patient who presented with signs and symptoms of late generalized peritonitis. The patient was operated under emergency conditions and diagnosed with splenic abscess rupture, for which splenectomy with drainage procedure was performed...
May 2018: Journal of Surgical Case Reports
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