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Retroperitoneal trauma

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https://www.readbyqxmd.com/read/30114500/endovascular-repair-of-iliac-vein-laceration-associated-to-complex-pelvic-fracture
#1
Vicente Mosquera, Carlota Fernández, Amer Zanabili, Jose A Del Castro, Mónica G Pandavenes, Manuel Alonso
BACKGROUND: Iliac vein injury associated with pelvic fracture due to blunt trauma is an uncommon and difficult diagnosis but a life-threatening condition which often requires an emergent management. Although open repair has been traditionally used as the treatment of choice in unstable patients, it is controversial, given the difficulty injured vessel exposure in patients with significant retroperitoneal hematoma as well as tamponade effect loss associated to laparotomy. We present a challenging case of iliac vein laceration successfully treated by placement of a self-expanding covered stent...
August 13, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/30072564/lesson-of-the-month-2-blunt-abdominal-trauma-atypical-presentation-of-phaeochromocytoma
#2
Sarah Faloon, Hema Venkataraman, Kassiani Skordilis, Ewen A Griffiths, Neil Jl Gittoes, Zaki K Hassan-Smith, John Ayuk
A 26-year-old man presented following blunt abdominal trauma to a regional major trauma centre for emergency embolisation of a retroperitoneal bleed from a presumed renal laceration. Imaging had also revealed a large right suprarenal mass. Embolisation resulted in a hypertensive crisis raising the suspicion of a metabolically active adrenal tumour. The course was further complicated by the development of ischaemic bowel requiring emergency laparotomy. Intraoperatively he became haemodynamically unstable from an actively haemorrhaging lesion...
August 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/30042248/-traumatic-disruption-of-the-aortic-root-and-the-ascending-aorta-with-multisystem-trauma-report-of-a-case
#3
Tetsuyuki Ueda, Masami Sotokawa, Akihiro Nakagaki, Kazuhiro Tani, Shingo Ohtaka, Akira Murata
We report a case of traumatic disruption of the aortic root with multisystem trauma. A 45-year-old male was suffered from multiple injuries including subarachnoid hemorrhage, lung contusion, retroperitoneal hematoma and femoral bone fracture caused by a traffic accident. He had a history of 3 cardiac surgeries including repair of atrioventricular septal defect and mitral valve replacement using a mechanical valve. Contrast-enhanced computed tomography (CT) revealed leakage of the contrast medium from the aortic root and a filling defect on the right coronary artery...
June 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/30017184/integrating-extended-focused-assessment-with-sonography-for-trauma-efast-in-the-initial-assessment-of-severe-trauma-impact-on-the-management-of-756-patients
#4
Laurent Zieleskiewicz, Raphaelle Fresco, Gary Duclos, François Antonini, Calypso Mathieu, Sophie Medam, Coralie Vigne, Marion Poirier, Pierre-Hugues Roche, Pierre Bouzat, François Kerbaul, Ugo Scemama, Thierry Bège, Pascal Alexandre Thomas, Xavier Flecher, Emmanuelle Hammad, Marc Leone
BACKGROUND: Before total body computed tomography scan, an initial rapid imaging assessment should be conducted in the trauma bay. It generally includes a chest x-ray, pelvic x-ray, and an extended focused ultrasonography assessment for trauma. This initial imaging assessment has been poorly described since the increase in the use of ultrasound. Therefore, our study aimed to evaluate the diagnostic accuracy and therapeutic impact of this initial imaging work-up in severe trauma patients...
July 8, 2018: Injury
https://www.readbyqxmd.com/read/29901544/limits-of-intravascular-contrast-extravasation-on-computed-tomography-scan-to-define-the-need-for-pelvic-angioembolization-in-pelvic-blunt-trauma-a-specific-assessment-on-the-risk-of-false-positives
#5
Séverin Ramin, Margaux Hermida, Ingrid Millet, Thibault Murez, Valérie Monnin, Mazen Hamoui, Xavier Capdevila, Jonathan Charbit
BACKROUND: The objective was to assess the predictive performance of different intravascular contrast extravasation (ICE) characteristics for need for pelvic transarterial embolization (TAE) to determine the risk factors of false-positives. METHODS: A retrospective study was performed in our trauma center between 2010 and 2015. All severe trauma patients with pelvic fracture were included. Pelvic ICE characteristics on computed tomography (CT) scan were studied: arterial (aSICE), portal surface (pSICE), and extension (exSICE) anatomic relationships...
June 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29774196/common-carotid-artery-dissection-in-multiple-extracranial-injury-a-case-report
#6
Jin Sang Kil, Mi Kyung Lee, Ki Seong Eom
Traumatic common carotid artery dissection (CCAD) is rare. To our knowledge, only 14 case reports have described traumatic CCAD previously. Here, we report a case of CCAD in a patient with severe trauma. A 50-year-old man was lying on the road after drinking alcohol when a car drove over him. Computed tomography (CT) revealed multiple rib fractures with hemopneumothorax, lung contusion, flail chest, large amount of hematoma with bladder rupture, and fractures on the C6 spinous process, sacral ala, iliac bone, and pubic ramus...
April 2018: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29662682/delayed-intestinal-perforation-secondary-to-blunt-force-abdominal-trauma-in-a-cat
#7
A Taylor, E Cooper, K Ham
Case summary: A 7-month-old intact male domestic shorthair cat was presented 4 h after being hit by a car. It had bilateral inguinal hernias and a mesenteric rent that were repaired surgically and a hematoma in the left retroperitoneal space. No other intra-abdominal abnormalities were identified on abdominal surgical exploration. Approximately 72 h after presentation, the cat started vomiting and developed severe abdominal discomfort. A sudden decrease in mentation and elevation of respiratory rate and effort ensued...
January 2018: JFMS Open Reports
https://www.readbyqxmd.com/read/29656797/approach-and-management-of-traumatic-retroperitoneal-injuries
#8
Patrizio Petrone, Cristina Magadán Álvarez, D'Andrea Joseph, Lee Cartagena, Fahd Ali, Collin E M Brathwaite
Traumatic retroperitoneal injuries constitute a challenge for trauma surgeons. They usually occur in the context of a trauma patient with multiple associated injuries, in whom invasive procedures have an important role in the diagnosis of these injuries. The retroperitoneum is the anatomical region with the highest mortality rates, therefore early diagnosis and treatment of these lesions acquire special relevance. The aim of this study is to present current published scientific evidence regarding incidence, mechanism of injury, diagnostic methods and treatment through a review of the international literature from the last 70 years...
May 2018: Cirugía Española
https://www.readbyqxmd.com/read/29649954/anatomical-considerations-and-open-surgery-to-treat-juxtarenal-abdominal-aortic-aneurysms
#9
Georgiana Samoila, Ian Michael Williams
INTRODUCTION: Historically, the open approach to the abdominal aorta has been transperitoneal (TP). In comparison, a retroperitoneal (RP) incision exposes the lateral wall of the suprarenal aorta for clamp application and midline structures such as the duodenum and pancreas are not encountered. Proximal clamp position for open repair of juxtarenal abdominal aortic aneurysm (JR-AAA) is suprarenal, supra-superior mesenteric, or supraceliac. While RP and TP approaches have previously been compared for physiological reasons, there are currently no randomized controlled trials comparing these methods from an anatomical perspective...
July 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29644270/importance-of-the-capability-for-complete-resuscitative-treatment-combining-surgery-and-interventional-radiology-for-potentially-lethal-multiple-injuries-a-case-report
#10
Hiroyuki Otsuka, Toshiki Sato, Keiji Sakurai, Hiromichi Aoki, Takeshi Yamagiwa, Shinichi Iizuka, Sadaki Inokuchi
Background: Recently, trauma management has been complicated owing to the introduction of damage-control strategies and interventional radiology. Here, we discuss important aspects regarding survival of patients with severe trauma. Case presentation: A 74-year-old Japanese woman experienced a traffic accident on a highway. On arrival, paramedics were unable to measure her blood pressure, and her condition deteriorated. The patient was immediately transferred to our hospital in a physician-staffed emergency helicopter, during which she was administered emergency blood transfusions...
October 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29615838/spontaneous-perirenal-urinoma-induced-by-nsaid-associated-acute-interstitial-nephritis
#11
Hsiu-Wen Chang, Chia-Hao Kuei, Chin-Feng Tseng, Yi-Chou Hou, Ying-Lan Tseng
Urinoma, defined as the urine leakage beyond the urinary tract, is commonly induced by blunt trauma or urinary tract obstruction by stone, intra-abdominal malignancy, or retroperitoneal fibrosis. Spontaneous urinoma is rare and parenchymal pathologic change is rarely mentioned when urinoma is found. We present a case of a 28-year-old woman with bilateral flank pain induced by spontaneous urinoma. The lady received chronic analgesics because of migraine. After intravenous ketorolac injection, bilateral perirenal urinoma developed...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29607721/removing-a-metal-foreign-object-successfully-from-a-patient-s-retroperitoneal-space-using-laparoscopy-and-a-novel-navigation-system
#12
J H Wu, Y Yuan, L Q Jiang, Y Xia, Y Wang, S G Xu, P Y Zhou
Trauma with foreign objects retained within the human body has become a common surgical emergency condition. Traditional surgical methods often involve creating large incisions in soft tissue and may lead to additional complications during wound healing. We have developed a new method of removing foreign bodies from patients' abdomens by using laparoscopy with the help of a novel navigation system that provides accurate positioning. This approach is minimally invasive and simple. This is the first combination of both technologies in this field...
May 2018: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29565953/unique-complications-of-percutaneous-endoscopic-lumbar-discectomy-and-percutaneous-endoscopic-interlaminar-discectomy
#13
Chuanli Zhou, Guoqing Zhang, Ripul R Panchal, Xianfeng Ren, Hongfei Xiang, Ma Xuexiao, Xiaoliang Chen, Gu Tongtong, Wang Hong, Alana D Dixson
BACKGROUND: Percutaneous endoscopic discectomy (PED) includes 2 main procedures: percutaneous endoscopic lumbar discectomy (PELD) and percutaneous endoscopic interlaminar discectomy (PEID), both of which are minimally invasive surgical procedures that effectively deal with lumbar degenerative disorders. Because of the challenging learning curve for the surgeon and the individual characteristics of each patient, preventing and avoiding complications is difficult. The most common complications, such as nucleus pulposus omission, nerve root injury, dural tear, visceral injury, nerve root induced hyperalgesia or burning-like nerve root pain, postoperative dysesthesia, posterior neck pain, and surgical site infection, are difficult to avoid; however, more focus on these issues perioperatively may be in order...
March 2018: Pain Physician
https://www.readbyqxmd.com/read/29563127/renal-injury-in-a-patient-with-lumbar-scoliosis
#14
Harjoat Riyat, Richard Jones, Debashis Sarkar, Richard Stephenson
Kidney laceration following blunt trauma is responsible for up to 3% of trauma cases. The risk factors associated with renal injury are attributed to the risks of mechanical injury. However, anatomical variations that may accelerate the insult of injury are poorly documented. This case report describes a 25-year-old with degenerative lumbar scoliosis who presented with flank pain and visible haematuria following a low-impact injury. The patient had a grade IV renal injury. The curvature of the spine, shown on CT imaging, revealed a reduced retroperitoneal space around the left kidney...
March 21, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29484938/the-spectrum-and-outcome-of-blunt-trauma-related-enteric-hollow-visceral-injury
#15
W Bekker, V Y Kong, G L Laing, J L Bruce, V Manchev, D L Clarke
Introduction This audit focused on patients who sustained enteric injury following blunt abdominal trauma. Methods Our prospectively maintained electronic registry was interrogated retrospectively, and all patients who had sustained blunt abdominal trauma between December 2011 and January 2016 were identified. Results Overall, 2,045 patients had sustained blunt abdominal trauma during the period under review. Seventy per cent were male. The median age was 28 years. Sixty patients (2.9%) sustained a small bowel injury (SBI)...
April 2018: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29483377/laparoscopic-management-of-retroperitoneal-injuries-from-penetrating-abdominal-trauma-in-haemodynamically-stable-patients
#16
Modise Zacharia Koto, Oleh Y Matsevych, Fusi Mosai, Moses Balabyeki, Colleen Aldous
Background: Laparoscopy is increasingly utilised in the trauma setting. However, its safety and reliability in evaluating and managing retroperitoneal injuries are not known. Aim: The aim of this study was to analyse our experience with laparoscopic management of retroperitoneal injuries due to penetrating abdominal trauma (PAT) and to investigate its feasibility, safety and accuracy in haemodynamically stable patients. Methods: Over a 4-year period, patients approached laparoscopically with retroperitoneal injuries were analysed...
February 27, 2018: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29438587/managing-penetrating-renal-trauma-experience-from-two-major-trauma-centres-in-the-uk
#17
Marios Hadjipavlou, Edmund Grouse, Robert Gray, Denosshan Sri, Dean Huang, Christian Brown, Davendra Sharma
OBJECTIVES: To present our series of patients with penetrating renal trauma treated at two urban major trauma centres and to discuss the contemporary management of such injuries. METHODS: We reviewed prospective urological trauma databases for all patients presenting with penetrating renal trauma between January 2005 and October 2016. Patient demographics, clinical characteristics, imaging, management and follow-up data were analysed. RESULTS: Over the 11-year period, 63 patients presented with penetrating renal injuries...
June 2018: BJU International
https://www.readbyqxmd.com/read/29419325/anatomic-distribution-of-hematoma-following-pelvic-fracture
#18
Narin Uludag, Anna Tötterman, Mats O Beckman, Anders Sundin
OBJECTIVE: To assess the extent of pelvic hemorrhage on CT and to estimate its significance on outcome in patients with blunt high-energy pelvic trauma. METHODS: 576 patients with blunt high-energy pelvic fractures in 2005-2011 were identified in the hospital's Trauma Registry (a major Trauma Center). 60 of these met our further inclusion criteria of initial systolic blood pressure ≤100 mmHg and pelvic-related hemorrhage. CT scans of the patients were reviewed with regard to pelvic and abdominal retroperitoneal hemorrhage, type of fracture (Tile classification) and associated injuries...
May 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29394769/-a-case-of-curatively-resected-ascending-colon-cancer-after-long-term-chemotherapy-found-in-abdominal-trauma
#19
Naoki Aomatsu, Yasutake Uchima, Chihoko Nobori, Shigeaki Kurihara, Yoshihito Yamakoshi, En Wang, Daisuke Nagashima, Toshiki Hirakawa, Takehiko Iwauchi, Junya Morimoto, Seika Tei, Kazunori Nakazawa, Kazuhiro Takeuchi
A 46-year old man presented with lower right quadrant abdominal pain caused by abdominal trauma. Abscess drainage was performed after the diagnosis of retroperitoneal abscess in the ileocecal portion of the colon. Type 2 advanced cancer was found in the cecum and ascending colon. Surgery was performed after improvement of inflammation. Considering the difficulty of curative resection for retroperitoneal invasion, we first performed ileo-transverse colon anastomosis. After surgery, the patient received FOLFOX with panitumumab(Pmab)as neoadjuvant chemotherapy...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29368084/radiological-classification-of-retroperitoneal-hematoma-resulting-from-lumbar-vertebral-fracture
#20
Shota Nakao, Kazuo Ishikawa, Hidefumi Ono, Kenji Kusakabe, Ichiro Fujimura, Masato Ueno, Koji Idoguchi, Yasuaki Mizushima, Tetsuya Matsuoka
PURPOSE: Lumbar vertebral fracture (LVF) infrequently produces massive retroperitoneal hematoma (RPH). This study aimed to systematically review the clinical and radiographic characteristics of RPH resulting from LVF. METHODS: For 193 consecutive patients having LVF who underwent computed tomography (CT), demographic data, physiological conditions, and outcomes were reviewed from their medical records. Presence or absence of RPH, other bone fractures, or organ/vessel injury was evaluated in their CT images, and LVF or RPH, if present, was classified according to either the Orthopaedic Trauma Association classification or the concept of interfascial planes...
January 24, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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