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abdominal vascular trauma

Dirk Stengel, Johannes Leisterer, Paula Ferrada, Axel Ekkernkamp, Sven Mutze, Alexander Hoenning
BACKGROUND: Point-of-care sonography (POCS) has emerged as the screening modality of choice for suspected body trauma in many emergency departments worldwide. Its best known application is FAST (focused abdominal sonography for trauma). The technology is almost ubiquitously available, can be performed during resuscitation, and does not expose patients or staff to radiation. While many authors have stressed the high specificity of POCS, its sensitivity varied markedly across studies. This review aimed to compile the current best evidence about the diagnostic accuracy of POCS imaging protocols in the setting of blunt thoracoabdominal trauma...
December 12, 2018: Cochrane Database of Systematic Reviews
Sirisha Grandhe, Joy A Lee, Ankur Chandra, Christopher Marsh, Catherine T Frenette
Abdominal pain with elevated transaminases from inferior vena cava (IVC) obstruction is a relatively common reason for referral and further workup by a hepatologist. The differential for the cause of IVC obstruction is extensive, and the most common etiologies include clotting disorders or recent trauma. In some situations the common etiologies have been ruled out, and the underlying process for the patient's symptoms is still not explained. We present one unique case of abdominal pain and hepatomegaly secondary to IVC constriction from extrinsic compression of the diaphragm...
November 27, 2018: World Journal of Hepatology
Shane Smith, John White, Kerollos Nashat Wanis, Andrew Beckett, Vivian C McAlister, Richard Hilsden
BACKGROUND: Junctional tourniquets have been incorporated into tactical combat casualty care for junctional vascular trauma. They apply external compression to stop blood flow in the groin and axilla. OBJECTIVES: The primary outcome was effectiveness in achieving arterial occlusion. Secondary outcomes included time to application and pain scores. DATA SOURCES: Medline and EMBASE databases were searched. STUDY APPRAISAL AND SYNTHESIS METHODS: A random effects meta-analysis was conducted to estimate the average effectiveness and time to effective application for each device...
November 30, 2018: Journal of Trauma and Acute Care Surgery
Jeffrey J Siracuse, Alik Farber, Thea James, Thomas W Cheng, Yi Zuo, Jeffrey A Kalish, Douglas W Jones, Bindu Kalesan
INTRODUCTION: Firearm injuries can be morbid and potentially have high resource utilization. Historically, trauma and vascular surgery patients are at higher risk for readmissions. Our goal was to assess the risk for readmission among patients undergoing vascular repair after a firearm injury. METHODS: The National Readmission Database was queried from 2011-2014. All firearm injuries with or without vascular repair were analyzed. Multivariable analysis was conducted to assess the effect of concurrent vascular repair on readmissions at 30, 90, and 180 days...
November 27, 2018: Annals of Vascular Surgery
Bernardino C Branco, Tashinga Musonza, Michael A Long, Jayer Chung, Samual R Todd, Matthew J Wall, Joseph L Mills, Ramyar Gilani
OBJECTIVE: Recent studies have demonstrated an increase in trauma mortality relative to mortality from cancer and heart diseases in the United States. Major vascular injuries such as to the inferior vena cava (IVC) and aortic injuries remain responsible for a significant proportion of early trauma deaths in modern trauma care. The purpose of this study was to explore patterns in epidemiology and mortality after IVC and aortic injuries in the United States. METHODS: A 13-year analysis of the National Trauma Databank (2002-2014) was performed to extract all patients who sustained IVC, abdominal aortic, or thoracic aortic injuries...
December 2018: Journal of Vascular Surgery
Kyoung Hoon Lim, Jinyoung Park
RATIONALE: Blunt injury of major visceral arteries such as celiac artery (CA) and superior mesenteric artery (SMA) are very rare but fatal, therefore, these injuries are challenging to trauma surgeons. The patient with occlusion of CA or SMA is theoretically viable by visceral collateral circulation. However, there are very rare cases in clinics. To date, there have been few reports of both CA and SMA occlusions after blunt trauma. Herein we describe our successful conservative treatment of patients with both CA and SMA occlusions...
November 2018: Medicine (Baltimore)
Visith Siriphuwanun, Yodying Punjasawadwong, Suwinai Saengyo, Kittipan Rerkasem
Purpose: The aim of this study was to determine the incidences and factors associated with perioperative cardiac arrest in trauma patients who received anesthesia for emergency surgery. Patients and methods: This retrospective cohort study was approved by the medical ethical committee, Faculty of Medicine, Maharaj Nakorn Chiang Mai Hospital, Thailand. Data of 19,683 trauma patients who received anesthesia between January 2007 and December 2016, such as patient characteristics, surgery procedures, anesthesia information, anesthetic drugs, and cardiac arrest outcomes, were analyzed...
2018: Risk Management and Healthcare Policy
Nada Faris Alhassan, Saad Mohammed Alsaawy, Ibrahim Tawfiq Albabtain
INTRODUCTION: Injury to the superior mesenteric vein (SMV) is considerably rare amongst abdominal visceral vascular injuries. Multiple factors play a role in identifying such injuries, leading to the high morbidity and mortality associated. CASE PRESENTATION: We report a twenty-six-year-old male sustaining a SMV injury following a self-inflected gun shot. Initial assessment of the patient reveals hemodynamic instability and intraabdominal hemorrhage. Surgically approaching the patient was performed in two stages...
2018: International Journal of Surgery Case Reports
Se Jong Kim, Su Joa Ahn, Seung Joon Choi, Dae Hong Park, Hyung Sik Kim, Jeong Ho Kim
OBJECTIVES: The aim of this study is to compare the radiologic diagnostic performance of arterial phase, portal phase and combined phase computed tomography (CT) for traumatic abdominal injury. In addition, this study is attempted to decrease lifetime attributable risks (LARs) of cancer due to radiation exposure by using optimal CT protocol. MATERIALS AND METHODS: A total of 114 consecutive patients with a traumatic abdominal injury and an abdominal hematoma on CT were enrolled at a single tertiary regional trauma center between January 2016 and March 2017...
October 12, 2018: American Journal of Emergency Medicine
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
Adenauer Marinho de Oliveira Góes Junior, Joaquim Fernando Albuquerque Simões Neto, Simone de Campos Vieira Abib, Mariseth Carvalho de-Andrade, Thaiana Cerqueira Ferraz
OBJECTIVE: to evaluate the epidemiological data of patients operated on due to vascular trauma at a referral hospital in Pará state, to determine the variables that increase the risk of death, and to make a comparative analysis with the results previously published by the same institution. METHODS: an analytical retrospective study was performed through data collection from patients operated due to vascular injuries, between March 2013 and March 2017. Demographic and epidemiological data, such as the mechanism and topography of the lesion, distance between the trauma site and the hospital, and type of treatment and complications, were analyzed...
October 4, 2018: Revista do Colégio Brasileiro de Cirurgiões
Jennifer L Wainright, Christopher L Wholley, John Rosendale, Wida S Cherikh, Darren Di Battista, David K Klassen
BACKGROUND: Vascularized composite allograft (VCA) transplants include diverse organ types and are made possible primarily by deceased donors. METHODS: We used Organ Procurement and Transplantation Network (OPTN) data to characterize VCA deceased donors (n=66 of 70) in the United States 1998-2017 and compare their characteristics with those of kidney donors in 2017. RESULTS: Through December 31, 2017, 20 transplant programs performed 72 deceased donor VCA transplants, with organs donated by 70 donors, including 30 upper limb (17 unilateral and 13 bilateral) and 11 face donors...
September 17, 2018: Transplantation
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
Kian Adabi, Oscar J Manrique, Aparna Vijayasekaran, Steven L Moran, Pedro Ciudad, Tony C T Huang, Fabio Nicoli, Sarah Bishop, Hung-Chi Chen
INTRODUCTION: Reconstruction of abdominal wall defects with enterocutaneous fistulas (ECF) remains challenging. The purpose of this report is to describe a single-stage approach using combined microscopic enterolysis, pedicle seromuscular bowel flaps, mesh, fasciocutaneous, and myocutaneous flaps. METHODS: Between 1990 and 2016 a retrospective review identified a total of 18 patients with an average age of 39 years (ranging 26-59 years). Thirteen cases were associated with trauma, four were complication of previous mesh repair, and one was after an aortic dissection...
September 3, 2018: Microsurgery
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
Ilaria Jane Romano, Francesco Gentile, Antonio Lippolis
Postmicturition syndrome refers to symptoms caused by overdistension of the bladder or micturition. Bladder paraganglioma is a rare neuroendocrine neoplasm, which arises from the chromaffin tissue of the sympathetic nervous system embedded in the muscle layer of the bladder wall. Clinical presentation of catecholamine-secreting paragangliomas may mimic that of hyperfunctioning adrenal pheochromocytoma. Typical symptoms such as sweating, palpitations, headache, nausea, hypertension, or flushing are due to catecholamine release and are related to micturition or bladder overdistension...
August 2018: Journal of the American Society of Hypertension: JASH
Melanie R Hoehn, Natasha Z Hansraj, Amelia M Pasley, Megan Brenner, Samantha R Cox, Jason D Pasley, Jose J Diaz, Thomas Scalea
BACKGROUND: Hemorrhagic shock is the second leading cause of death in blunt trauma and a significant cause of mortality in non-trauma patients. The increased use of resuscitative endovascular balloon occlusion of the aorta (REBOA) as a bridge to definitive control for massive hemorrhage has provided promising results in the trauma population. We describe an extension of this procedure to our hemodynamically unstable non-trauma patients. METHODS: This is a retrospective review of patients requiring REBOA for end stage non-traumatic abdominal hemorrhage from our tertiary care facility...
June 19, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Amee M Bigelow, Katherine T Flynn-O'Brien, Pippa M Simpson, Mahua Dasgupta, Sheila J Hanson
OBJECTIVES: Frequency of venous thromboembolism in pediatric trauma patients admitted to PICUs is not insignificant, ranging up to 6%. Risk factors have been identified in this population. However, there is little consensus of actual venous thromboembolism prophylaxis practice. We examined factors associated with venous thromboembolism prophylaxis in PICUs. DESIGN: A retrospective study evaluating associations with mechanical venous thromboembolism prophylaxis, pharmacologic venous thromboembolism prophylaxis, or dual therapy (DUAL) prophylaxis compared with no venous thromboembolism prophylaxis...
September 2018: Pediatric Critical Care Medicine
Camille Choufani, Olivier Barbier, Aurélie Mayet, Sylvain Rigal, Laurent Mathieu
Introduction: A deployed military orthopedic surgeon is a trauma surgeon working in austere conditions. The first aim of this study was to analyze the current activity of French military orthopedic surgeons in the field and to identify the differences of the combat zone with their daily practice. The second aim was to assess the adequacy of the preparedness they received before their deployment and to identify additional needs that could be addressed in future training. Methods: An evaluation survey was sent to all French military orthopedic surgeons deployed in theaters of operations between 2004 and 2014...
June 13, 2018: Military Medicine
Sebastian Eduardo Velez
Background: nonoperative treatment (TNO) is suggested in blunt abdominal trauma in stable patients without necessarily addressing surgical trauma injuries. Among the tools used, it has highlighted the angioembolization as a method of stopping bleeding or potentially bleeding lesions. The existence of more than one lesion may be possible to treat this way. Objectives: to show the experience of a hospital emergency department in the use of angioembolization in nonoperative management of more than one injured abdominal organ...
September 8, 2017: Revista de la Facultad de Ciencias Médicas
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