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Abdomen trauma

Abhishek Chaturvedi, Prabhakar Rajiah, Apeksha Chaturvedi
Acquired diaphragmatic defects occur secondary to trauma, infection, surgery or neoplasm. These defects can lead to abnormal thoraco-abdominal fistulous communications also. Examples of surgically created diaphragmatic defects are omental, colonic interposition and vascular grafts. Regardless of etiology, these transdiaphragmatic communications provide a direct path for spread of pathology between the abdomen and thorax. If left untreated and unrecognized, these fistulae portend a high morbidity and mortality...
October 6, 2018: Clinical Imaging
Celiac trunk is the artery of foregut, arising from the abdominal aorta at the level of T12/L1 vertebral body. It extends approximately 1.5 to 2 cm horizontally forwards before dividing into three branches: left gastric, common hepatic, and splenic arteries. Out of the three ventral branches of abdominal aorta, celiac trunk is more prone to have variations. During routine dissection of abdomen for undergraduate students we found some rare variations in the branching pattern of the celiac trunk. Absence of celiac trunk with hepatomesenteric trunk, quadrifurcation with dorsal pancreatic artery arising from it, quadrifurcation with middle colic artery arising from it, left inferior phrenic artery arising from celiac trunk, highly tortuous splenic artery supplying distal 1/3rd of transverse colon and hepatosplenic trunk...
September 2018: Anatomy & Cell Biology
Luis Servia, José C E Serrano, Reinald Pamplona, Mariona Badia, Neus Montserrat, Manuel Portero-Otin, Javier Trujillano
Though circulating antioxidant capacity in plasma is homeostatically regulated, it is not known whether acute stressors (i.e. trauma) affecting different anatomical locations could have quantitatively different impacts. For this reason, we evaluated the relationship between the anatomical location of trauma and plasma total antioxidant capacity (TAC) in a prospective study, where the anatomical locations of trauma in polytraumatic patients (n = 66) were categorized as primary affecting the brain -traumatic brain injury (TBI)-, thorax, abdomen and pelvis or extremities...
2018: PloS One
Christopher J Goodenough, Tyler A Cobb, John B Holcomb
Resuscitative endovascular balloon occlusion of the aorta (REBOA) has become an increasingly popular alternative to emergency thoracotomy and aortic cross-clamping in patients with exsanguinating hemorrhage.1 This new capability is increasingly being used in non-trauma situations.2 3 This report demonstrates another novel use of REBOA for iatrogenic intra-abdominal hemorrhage. An 83-year-old man with multiple medical comorbidities and a history of chronic mesenteric ischemia was admitted to our institution for an elective mesenteric revascularization...
2018: Trauma surgery & acute care open
Federico Coccolini, Marco Ceresoli, Yoram Kluger, Andrew Kirkpatrick, Giulia Montori, Fracensco Salvetti, Paola Fugazzola, Matteo Tomasoni, Massimo Sartelli, Luca Ansaloni, Fausto Catena
INTRODUCTION: No definitive data describing associations between cases of Open Abdomen (OA) and Entero-atmospheric fistulae (EAF) exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) thus analyzed the International Register of Open Abdomen (IROA) to assess this question. MATERIAL AND METHODS: A prospective analysis of adult patients enrolled in the IROA. RESULTS: Among 649 adult patients with OA 58 (8...
September 24, 2018: Injury
Chethan Sathya, Aziz S Alali, Paul W Wales, Jacob C Langer, Brian D Kenney, Randall S Burd, Michael L Nance, Avery B Nathens
BACKGROUND: Trauma is a common indication for computed tomography (CT) in children. However, children are particularly vulnerable to CT radiation and its associated cancer risk. Identifying differences in CT usage across trauma centers and among specific populations of injured children is needed to identify where quality improvement initiatives could be implemented in order to reduce excess radiation exposure to children. We evaluated computed tomography (CT) rates among injured children treated at pediatric (PTC), mixed (MTC), or adult trauma centers (ATC) and estimated the resulting differential in potential cancer risk...
September 19, 2018: Injury
Hannah Samuelson, Giovanni Giannotti, Thomas Malvar
•Urologists and health care professionals alike need to recognize the risks and complications that come with clot formation in urine and the use of CBI, especially subsequent bladder rupture.•Prior history of chronic, prolonged BPH has implications and complications that need to be considered when hematuria with blood clots arise and urologic procedures are performed.•This case is presented to highlight the importance of surveillance of hematuria with presence of clots, as well as the importance of regulated control of CBI...
November 2018: Urology Case Reports
Samarth Agarwal, Ashish Sharma, Akansha Gupta, Satya Narayan Sankwar
Post-traumatic vesicocutaneous fistula (VCF) is a rare variant of urinary fistulas. These fistulas may externally communicate to abdomen, perineum, buttocks, scrotum or very rarely thigh. These fistulas usually develop at a variable time duration after trauma and are usually preceded with thigh swelling or abscess formation followed by spontaneous rupture. We, hereby, report a case of VCF of bilateral thighs with associated penobulbar urethral stricture after road traffic accident which was managed with dual modality of buccal mucosa graft urethroplasty surgery and cyanoacrylate glue injection in the fistulous tracts...
September 25, 2018: BMJ Case Reports
Micaela Piccoli, Ferdinando Agresta, Grazia Maria Attinà, Dalia Amabile, Domenico Marchi
To date, there is no shared consensus on a definition of a complex abdominal wall in elective surgery and in the emergency, on indications, technical details, complications, and follow-up. The purpose of the conference was to lay the foundations for a homogeneous approach to the complex abdominal wall with the primary intent being to attain the following objectives: (1) to develop evidence-based recommendations to define "complex abdominal wall"; (2) indications in emergency and in elective cases; (3) management of "complex abdominal wall"; (4) techniques for temporary abdominal closure...
September 25, 2018: Updates in Surgery
Noritoshi Mizuta, Kozo Tsunemi
Desmoid tumors are rare, monoclonal myofibroblastic neoplasms that occur in the extremities, the trunk, and the abdominal cavity. We present a case that is significant for its rarity and for consideration of its treatment plan. A 17-year-old male reported swelling of his abdomen and abdominal pain. He was referred to our hospital with no history of surgery, trauma, or familial adenomatous polyposis. A large tumor in the abdominal cavity was detected by computed tomography, and surgical resection was performed...
2018: Case Reports in Surgery
Doaa Ahmed Mansour, Ahmed Mohammed Elshaer, Mostafa Abd-Rahman Elshazly
PURPOSE: Abdominal shotgun injuries derive their significance from the wide range of injuries they cause. The management of this type of injury has been continuously evolving. Despite the ongoing incorporation of laparoscopy in management of abdominal trauma, there is no definite protocol raising the role of laparoscopy in such injuries. In this study, we outlined a tailored protocol in the management of penetrating abdominal shotgun injuries differing from the previous protocols which comprised either mandatory exploration or non-operative management...
September 24, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Parker Hu, Rindi Uhlich, Frank Gleason, Jeffrey Kerby, Patrick Bosarge
Background: Damage control surgery has revolutionized trauma surgery. Use of damage control surgery allows for resuscitation and reversal of coagulopathy at the risk of loss of abdominal domain and intra-abdominal complications. Temporary abdominal closure is possible with multiple techniques, the choice of which may affect ability to achieve primary fascial closure and further complication. Methods: A retrospective analysis of all trauma patients requiring damage control laparotomy upon admission to an ACS-verified level one trauma center from 2011 to 2016 was performed...
2018: World Journal of Emergency Surgery: WJES
Daniel J Gittings, Jonathan R Dattilo, George Fryhofer, Derek J Donegan, Keith Baldwin
Introduction: The ilioinguinal approach for psoas recession over the pelvic brim allows for direct visualization and protection of the femoral nerve while preserving hip flexion strength. Indications & Contraindications: <AbstractText Label="Step 1 Patient Positioning Preoperative Assessment and Draping" NlmCategory="UNASSIGNED">With the patient supine and anesthetized, perform the Thomas test, administer antibiotics, and drape to provide access to the inferior aspect of the abdomen, ilioinguinal region, and lower limb...
September 28, 2017: JBJS Essential Surgical Techniques
Sharfuddin Chowdhury, Abdullah Maher Alenazi, Yam Alwi Alharthi
BACKGROUND: Meckel's diverticulum, with an incidence of 2%, is the most common congenital anomaly in the gastrointestinal tract. Its main complications are perforation, obstruction, and bleeding. A few studies have reported that blunt abdominal trauma may result in perforation or obstruction to Meckel's diverticulum. However, reports of significant major intestinal bleeding from Meckel's diverticulum as a complication of blunt abdominal trauma is rare. This paper present what we believe to be the first reported case of significant intestinal bleeding from a Meckel's diverticulum following blunt abdominal trauma...
September 19, 2018: Journal of Medical Case Reports
Mircea Muresan, Simona Muresan, Klara Brinzaniuc, Daniela Sala, Radu Neagoe
INTRODUCTION: Open abdomen is a concept that was developed especially in relation to abdominal compartment syndrome (ACS). OBJECTIVE: This study presents the evolution and complications related to the management of the open abdomen after decompressive laparotomy, using a standardized method based on negative pressure wound therapy (NPWT). MATERIALS AND METHODS: This observational prospective study conducted over a 9-month period included 19 patients who underwent decompressive laparotomies for ACS...
August 13, 2018: Wounds: a Compendium of Clinical Research and Practice
Luis R Taveras, Jonathan B Imran, Holly B Cunningham, Tarik D Madni, Roberto Taarea, Allison Tompeck, Audra T Clark, Natalie Provenzale, Folarin M Adeyemi, Christian T Minshall, Alexander L Eastman, Michael W Cripps
BACKGROUND: Open abdomen (OA) and temporary abdominal closure (TAC) are common techniques to manage several surgical problems in trauma and emergency general surgery (EGS). Patients with an OA are subjected to prolonged mechanical ventilation. This can lead to increased rates of ventilator-associated pneumonia (VAP). We hypothesized that patients who were extubated with an OA would have a decrease in ventilator hours and as a result would have a lower rate of VAP without an increase in extubation failures...
September 11, 2018: Journal of Trauma and Acute Care Surgery
Caitlin Hardy, Joshua P Hazelton, Ron Gefen
PURPOSE: Fractures of the thoracolumbar spine account for up to 90% of spinal fractures, and are associated with significant disability. The advantage of acquiring dedicated spine CT imaging in addition to visceral CT studies of the chest, abdomen and pelvis for detection of spinal fractures has not been definitively established. This retrospective study seeks to determine the contribution of dedicated spine CT in the acute clinical setting. METHODS: Patients who were diagnosed with fractures of the thoracic or lumbar spine at our institution between January 1, 2010 and June 30, 2014 were identified...
August 13, 2018: Current Problems in Diagnostic Radiology
Samuel A Tisherman, Deborah M Stein
OBJECTIVES: To describe the current state of the art regarding management of the critically ill trauma patient with an emphasis on initial management in the ICU. DATA SOURCES AND STUDY SELECTION: A PubMed literature review was performed for relevant articles in English related to the management of adult humans with severe trauma. Specific topics included airway management, hemorrhagic shock, resuscitation, and specific injuries to the chest, abdomen, brain, and spinal cord...
September 7, 2018: Critical Care Medicine
Fikri M Abu-Zidan, Husni S Shalak, Mohammed A Alhaddad
Introduction: Ultrasound is an extension of the clinical examination and its findings should be correlated with the clinical picture as a whole to be useful. Hereby, we report a unique negative diagnostic ultrasound finding in blunt abdominal trauma which was not reported before. Clinical presentation: A 50-year-old obese man presented complaining of severe generalized abdominal pain and inability to pass urine of three days duration after he slipped on his abdomen...
September 2018: Turkish Journal of Emergency Medicine
Mustafa Yener Uzunoglu, Fatih Altintoprak, Enis Dikicier, Ismail Zengin
Objectives: Although non-traumatic Small Bowel Perforations (SBPs) are rare, they have high rates of morbidity and mortality in case of late presentation. Aetiological factors vary across different geographical regions. In this paper, SBPs caused by anything other than trauma and other well-known causes are presented and the current literature is reviewed. Methods: The study was conducted at General Surgery Clinics of two different tertiary university hospitals between January 2008 and September 2016...
July 2018: Pakistan Journal of Medical Sciences Quarterly
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