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Whole body trauma ct

S J Lochner, M Scherr, M Perl, C Grove
An approximately 25-year-old skier collided in a ski-run intersection. At high speed, he first hit another skier and then smashed into a snow cannon. He died from his injuries a short time later in hospital. A whole-body CT scan was conducted under resuscitation conditions, which was followed by an autopsy. The investigation revealed a severe blunt thoracic trauma as cause of death. The detailed analysis was the result of the combination of the two methods of investigation, CT scan and autopsy. The methods complemented each other effectively and allowed for a detailed presentation of the injury pattern...
January 4, 2017: Der Unfallchirurg
Pierre Pezy, Alexandros N Flaris, Nicolas J Prat, François Cotton, Peter W Lundberg, Jean-Louis Caillot, Jean-Stéphane David, Eric J Voiglio
Importance: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an innovative procedure in the treatment of noncompressible truncal hemorrhage. However, readily available fluoroscopy remains a limiting factor in its widespread implementation. Several methods have been proposed to perform REBOA without fluoroscopic guidance, and these methods were adapted predominantly from the military theater. Objective: To develop a method for performing REBOA in a civilian population using a standardized distance from a set point of entry...
December 14, 2016: JAMA Surgery
Jody C DiGiacomo, L D George Angus, Edward Coffield
BACKGROUND: Prior to the advent of whole body computed tomography, injuries of the adrenal gland were almost exclusively identified on postmortem examinations and were associated with severe injury. Recent literature has continued to identify an association between adrenal injuries and high ISS. The purpose of this study was to assess the influence of adrenal trauma on ISS and mortality while controlling for potential confounding factors. METHODS: A 15-year retrospective review for all adrenal gland injuries from a Level 1 Trauma Center's Trauma Registry was performed...
November 23, 2016: World Journal of Surgery
Lukas L Negrin, Gabriel Halat, Helmut Prosch, Michael Hüpfl, Stefan Hajdu, Thomas Heinz
BACKGROUND: Biomarkers caused by blunt chest trauma might leak into the vascular compartment and therefore reflect the severity of parenchymal lung injury (PLI). Five promising proteins were preselected after a literature scan. The objective of our study was to identify a biomarker that is released abundantly into the serum shortly after trauma and reliably quantifies the loss of functional lung tissue. METHODS: Polytraumatized patients (aged ≥18 years, Injury Severity Score [ISS] ≥16) were included in our prospective observational study if they were admitted directly to our level I trauma center during the first hour after trauma occurred...
November 16, 2016: Annals of Thoracic Surgery
Melissa K James, Sebastian D Schubl, Michael P Francois, Geoffrey K Doughlin, Shi-Wen Lee
STUDY OBJECTIVE: The aim of this study is to determine if the introduction of a pan-scan protocol during the initial assessment for blunt trauma activations would affect missed injuries, incidental findings, treatment times, radiation exposure, and cost. METHODS: A 6-month prospective study was performed on patients with blunt trauma at a level 1 trauma center. During the last 3 months of the study, a pan-scan protocol was introduced to the trauma assessment. Categorical data were analyzed by Fisher exact test and continuous data were analyzed by Mann-Whitney nonparametric test...
January 2017: American Journal of Emergency Medicine
Zhi-Jie Hong, Cheng-Jueng Chen, Jyh-Cherng Yu, De-Chuan Chan, Yu-Ching Chou, Chia-Ming Liang, Sheng-Der Hsu
We aimed to evaluate the benefit of whole-body computed tomography (WBCT) scanning for unconscious adult patients suffering from high-energy multiple trauma compared with the conventional stepwise approach of organ-selective CT.Totally, 144 unconscious patients with high-energy multiple trauma from single level I trauma center in North Taiwan were enrolled from January 2009 to December 2013. All patients were managed by a well-trained trauma team and were suitable for CT examination. The enrolled patients are all transferred directly from the scene of an accident, not from other medical institutions with a definitive diagnosis...
September 2016: Medicine (Baltimore)
Ferdia Bolster, Ken Linnau, Steve Mitchell, Eric Roberge, Quynh Nguyen, Jeffrey Robinson, Bruce Lehnert, Joel Gross
The aims of this article are to describe the events of a recent mass casualty incident (MCI) at our level 1 trauma center and to describe the radiology response to the event. We also describe the findings and recommendations of our radiology department after-action review. An MCI activation was triggered after an amphibious military vehicle, repurposed for tourist activities, carrying 37 passengers, collided with a charter bus carrying 45 passengers on a busy highway bridge in Seattle, WA, USA. There were 4 deaths at the scene, and 51 patients were transferred to local hospitals following prehospital scene triage...
September 13, 2016: Emergency Radiology
R Hinzpeter, T Boehm, D Boll, C Constantin, F Del Grande, V Fretz, S Leschka, T Ohletz, M Brönnimann, S Schmidt, T Treumann, P-A Poletti, Hatem Alkadhi
OBJECTIVES: To identify imaging algorithms and indications, CT protocols, and radiation doses in polytrauma patients in Swiss trauma centres. METHODS: An online survey with multiple choice questions and free-text responses was sent to authorized level-I trauma centres in Switzerland. RESULTS: All centres responded and indicated that they have internal standardized imaging algorithms for polytrauma patients. Nine of 12 centres (75 %) perform whole-body CT (WBCT) after focused assessment with sonography for trauma (FAST) and conventional radiography; 3/12 (25 %) use WBCT for initial imaging...
September 5, 2016: European Radiology
Gaspar Alberto Motta-Ramírez
BACKGROUND: Trauma is the most common cause of death in young adults. A multidisciplinary trauma team consists of at least a surgical team, an anesthesiology team, radiologic team, and an emergency department team. OBJECTIVE: Recognize the integration of multidisciplinary medical team in managing the trauma patient and which must include the radiologist physician responsible for the institutional approach to the systematization of the trauma patient regarding any radiological and imaging study with emphasis on the FAST (del inglés, Focused Assessment with Sonography in Trauma)/USTA, Whole body computed tomography...
July 2016: Gaceta Médica de México
Mario Morgenstern, Christian von Rüden, Hauke Callsen, Jan Friederichs, Sven Hungerer, Volker Bühren, Alexander Woltmann, Christian Hierholzer
INTRODUCTION: The thoracic cage is an anatomical entity composed of the upper thoracic spine, the ribs and the sternum. The aims of this study were primarily to analyse the combined injury pattern of thoracic cage injuries and secondarily to evaluate associated injuries, trauma mechanism, and clinical outcome. We hypothesized that the sternal fracture is frequently associated with an unstable fracture of the thoracic spine and that it may be an indicator for unstable thoracic cage injuries...
August 29, 2016: Injury
Muhanad M Hatamleh, Gurprit Bhamrah, Francine Ryba, Gavin Mack, Chrisopher Huppa
This patient report describes simultaneous bimaxillary orthognathic surgery and mandibular reconstruction by means of three-dimensional (3D) planning, 3D printed biocompatible surgical wafers, and 3D selective-laser sintered titanium implant. A 26-year-old male patient presented with a left mandibular defect secondary to trauma. The whole body of the mandible on the left hand side was deficient with a narrow connection with the remaining left condyle. He had undergone orthodontic treatment for 18 months and was ready to undergo bimaxillary orthognathic surgery...
October 2016: Journal of Craniofacial Surgery
Sophie Rym Hamada, Nathalie Delhaye, Sebastien Kerever, Anatole Harrois, Jacques Duranteau
BACKGROUND: The initial management of a trauma patient is a critical and demanding period. The use of extended focused assessment sonography for trauma (eFAST) has become more prevalent in trauma rooms, raising questions about the real "added value" of chest X-rays (CXRs) and pelvic X-rays (PXR), particularly in haemodynamically stable trauma patients. The aim of this study was to evaluate the effectiveness of a management protocol integrating eFAST and excluding X-rays in stable trauma patients...
December 2016: Annals of Intensive Care
J Frandon, C Arvieux, F Thony
Abdominal trauma accounts for nearly 20% of all traumatic injuries. It often involves young patients sustaining multiple injuries, with a high associated mortality rate. Management should begin at the scene of injury and relies on a structured chain of care in order to transport the trauma patient to the appropriate hospital center. Management is multi-disciplinary, involving intensive care specialists, surgeons and radiologists. Imaging to precisely define injury is best performed with whole body dual phase computed tomography, which can also identify the source of bleeding...
August 2016: Journal of Visceral Surgery
Maiko Atari, Yuki Nakajima, Mitsuro Fukuhara, Yoshihito Iijima, Hiroyasu Kinoshita, Yoshihiro Minamiya, Hidetaka Uramoto
In thoracic surgery, we occasionally encounter vessel anomalies. We herein report an extremely rare surgical case with the absence of the azygos vein. Mediastinal vascular abnormalities are said to be rare. The etiology of vascular abnormalities of the whole body, including the chest is known gene mutations, hormone abnormalities, infection, and trauma. But, many causes have been unknown. In thoracic surgery field, there is some reports and literature about pulmonary arteriovenous malformation, pulmonary sequestration, and partial anomalous pulmonary venous return...
June 4, 2016: Surgical and Radiologic Anatomy: SRA
Ozlem Bingol, Cuneyt Ayrık, Ataman Kose, Seyran Bozkurt, Huseyin Narcı, Didem Ovla, Meltem Nass Duce
OBJECTIVES: Using whole-body multislice computed tomography (MSCT) excessively or with irrelevant indications can be seen in many centers. The aim of this study was to analyze retrospectively the MSCT findings in trauma patients admitted to the emergency department. METHODS: Records of the patients who have applied to the emergency department due to blunt trauma in a 12 month period and whose whole body MSCT images have been taken, were evaluated using the "Nucleus Medical Information System"...
September 2015: Turkish Journal of Emergency Medicine
Wasim Hakim, Raghavendra Kamanahalli, Elizabeth Dick, Nishat Bharwani, Shirley Fetherston, Elika Kashef
OBJECTIVE: To compare the image quality of conventional arterial and portal venous (PV) phase multidetector CT (MDCT) with two biphasic injection protocols in polytrauma patients. METHODS: 60 consecutive patients with polytrauma underwent body 256-slice MDCT with a conventional protocol or 1 of 2 single-pass biphasic protocols: Group A, arterial (30 s) and PV (60 s) phase acquisitions; Group B, "biphasic" contrast injection with a single acquisition at 60 s; and Group C, "modified biphasic" injection with a single acquisition at a 70-s delay...
July 2016: British Journal of Radiology
Benjamin Bockmann, Sonja Soschynski, Philipp Lechler, Tim Schwarting, Florian Debus, Bogdan Soca, Steffen Ruchholtz, Michael Frink
BACKGROUND: A precise understanding of glenohumeral anatomy is required to optimize preoperative planning in shoulder joint arthroplasty, which is difficult in the presence of degenerative disease. In unilateral disease, the contralateral shoulder can be used as a representation of normal anatomy; however, intrasubject differences in shoulder morphology have not been investigated. METHODS: A retrospective study of all patients aged >65 years who received whole body computed tomography at our trauma center from 2010 through 2014 was conducted...
August 2016: Journal of Shoulder and Elbow Surgery
Maggie J Lin, Noran Barry, Ikemefuna Akusoba, Heidi H Hon, Marissa S Cohen, Pratik Shukla, James Cipolla, Stanislaw P Stawicki, Brian A Hoey
BACKGROUND: Decreases in the rates of traditional autopsy (TA) negatively impact traumatology, especially in the areas of quality improvement and medical education. To help enhance the understanding of trauma-related mortality, a number of initiatives in imaging autopsy (IA) were conceived, including the postmortem computed tomography ("CATopsy") project at our institution. Though IA is a promising concept, few studies directly correlate TA and IA findings quantitatively. Here, we set out to increase our understanding of the similarities and differences between key findings on TA and IA in a prospective fashion with blinding of pathologist and radiologist evaluations...
July 2016: Surgery
Jessica Chan, Christopher Johnson, Gillian Beran-Maryott, Janet Cortez, Thomas H Greene, Raminder Nirula, Marta Heilbrun
RATIONALE AND OBJECTIVES: Whole-body computed tomography (WBCT) imaging has become commonplace in some emergency departments (EDs) for trauma where management is dependent on rapid diagnosis achieved through comprehensive imaging. The purpose of this study was to assess the value that computed tomography (CT) imaging contributes to trauma patients by retrospectively comparing hospital length of stay (LOS) between WBCT and selective CT imaging, while controlling for hemodynamic stability and socio-economic considerations...
May 2016: Academic Radiology
D F W Maclean, N Vannet
AIM: To improve the practice of trauma computed tomography (CT) within Wales using recognised leadership techniques for change. MATERIALS AND METHODS: Royal College of Radiologists' (RCR) guidance, in addition to other key recent evidence, were used to form an aspirational standard. All centres across Wales with a major emergency department were included. Kotter's theory of change was utilised to facilitate an improvement in practice across the region, with larger units prioritised initially...
May 2016: Clinical Radiology
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