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Abdominal trauma

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https://www.readbyqxmd.com/read/28210364/caudal-edge-of-the-liver-in-the-right-upper-quadrant-ruq-view-is-the-most-sensitive-area-for-free-fluid-on-the-fast-exam
#1
Viveta Lobo, Michelle Hunter-Behrend, Erin Cullnan, Rebecca Higbee, Caleb Phillips, Sarah Williams, Philips Perera, Laleh Gharahbaghian
INTRODUCTION: The focused assessment with sonography in trauma (FAST) exam is a critical diagnostic test for intraperitoneal free fluid (FF). Current teaching is that fluid accumulates first in Morison's pouch. The goal of this study was to evaluate the "sub-quadrants" of traditional FAST views to determine the most sensitive areas for FF accumulation. METHODS: We analyzed a retrospective cohort of all adult trauma patients who had a recorded FAST exam by emergency physicians at a Level I trauma center from January 2012 - June 2013...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28209449/maxillofacial-and-concomitant-serious-injuries-an-eight-year-single-center-experience
#2
Fausto Fama, Marco Cicciu, Alessandro Sindoni, Enrico Nastro-Siniscalchi, Roberto Falzea, Gabriele Cervino, Francesca Polito, Francesco De Ponte, Maria Gioffre-Florio
PURPOSE: Maxillofacial injuries are frequently associated with multiple trauma and can determine functional and aesthetic bad outcomes. The severity of maxillofacial injuries may be considerable and can divert clinicians' attention from other concomitant injuries which is less evident but potentially life-threatening. The aim of this study was to find out the concomitant injuries in patients referred to the Emergency Department (ED) of the University Hospital of Messina (North-East Sicily, Italy) for maxillofacial traumas...
January 20, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28207376/hookworm-infection-in-south-american-fur-seal-arctocephalus-australis-pups
#3
M Seguel, F Muñoz, M J Navarrete, E Paredes, E Howerth, N Gottdenker
Tissues of South American fur seal pups naturally infected with hookworms ( Uncinaria sp) were examined. Hookworm infection was found in nearly all pups examined (132/140, 94%), and hookworm enteritis with secondary bacteremia was considered the cause of death in 46 (35%) pups. Common findings in these pups included severe hemorrhagic enteritis and numerous (mean intensity = 761.8) hookworms in the jejunum. Hookworms were recovered from the abdominal cavity in 12 of 55 pups (22%) examined through peritoneal wash; these pups had an average of 1343...
March 2017: Veterinary Pathology
https://www.readbyqxmd.com/read/28197781/sclerosing-mesenteritis-a-systematic-review-of-192-cases
#4
REVIEW
Prabin Sharma, Siddhartha Yadav, Christine Marie Needham, Paul Feuerstadt
INTRODUCTION: Sclerosing mesenteritis includes a spectrum of inflammatory disorders involving the adipose tissue of the bowel mesentery. AIM: To perform a systematic review of previously reported cases of sclerosing mesenteritis (SM) to determine the epidemiology, risk factors, methods of diagnosis, treatment patterns and outcomes for this disease. METHODS: Medline, PubMed, Google Scholar and Cochrane database were searched using keywords mesenteric panniculitis, retractile mesenteritis, mesenteric lipodystrophy and sclerosing mesenteritis...
February 14, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28196654/imaging-of-unilateral-adrenal-hemorrhages-in-patients-after-blunt-abdominal-trauma-report-of-two-cases
#5
Asli Tanrivermis Sayit, Emrah Sayit, Hediye Pinar Gunbey, Kerim Aslan
Adrenal hemorrhage following blunt abdominal trauma is extremely rare. Most of the lesions are unilateral and right sided. Although often asymptomatic, life-threatening adrenal insufficiency may develop in the bilateral adrenal gland hemorrhage. Isolated adrenal injuries are very rare. They are often associated with other organ injuries. The mortality rates of patients range from 7% to 32%. In this report, we present the computed tomography and magnetic resonance imaging findings of unilateral adrenal hemorrhages in two patients with a history of fall from a height...
January 19, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28193544/current-approach-to-liver-traumas
#6
Levent Kaptanoglu, Necmi Kurt, Hasan Ediz Sikar
INTRODUCTION: Liver injuries remain major obstacle for successful treatment, due to size and location of the liver. Requirement for surgery should be determined by clinical factors, most notably hemodynamical state. In this present study we tried to declare our approach to liver traumas. We also tried to emphasize the importance of conservative treatment, since surgeries for liver traumas carry high mortality rates. PRESENTATION OF CASE: Patients admitted to the Department of Emergency Surgery at Kartal Research and Education Hospital, due to liver trauma were retrospectively analyzed between 2003-2013...
February 10, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28190583/fibrinogen-is-an-independent-predictor-of-mortality-in-major-trauma-patients-a-five-year-statewide-cohort-study
#7
Zoe K McQuilten, Erica M Wood, Michael Bailey, Peter A Cameron, David J Cooper
INTRODUCTION: Fibrinogen may be reduced following traumatic injury due to loss from haemorrhage, increased consumption and reduced synthesis. In the absence of clinical trials, guidelines for fibrinogen replacement are based on expert opinion and vary internationally. We aimed to determine prevalence and predictors of low fibrinogen on admission in major trauma patients and investigate association of fibrinogen levels with patient outcomes. PATIENTS AND METHODS: Data on all major trauma patients (January 2007-July 2011) identified through a prospective statewide trauma registry in Victoria, Australia were linked with laboratory and transfusion data...
November 21, 2016: Injury
https://www.readbyqxmd.com/read/28190515/early-experience-with-a-split-bolus-single-pass-ct-protocol-in-paediatric-trauma
#8
V J Leung, M Grima, N Khan, H R Jones
AIM: To determine the adequacy of the split-bolus computed tomography (CT) technique in terms of vascular enhancement and solid-organ injury assessment in paediatric trauma. MATERIALS AND METHODS: A retrospective review was undertaken of all split-bolus trauma CT examinations performed in patients <16 years during the period from 1 January 2015 to 31 January 2016. Twelve examinations were performed in this time on patients with an age range of 2-15 years (mean 10...
February 9, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28188036/outcomes-of-an-accelerated-care-pathway-for-pediatric-blunt-solid-organ-injuries-in-a-public-healthcare-system
#9
Oluwatomilayo Daodu, Mary Brindle, Carlos R Alvarez-Allende, Lisette Lockyer, Bryce Weber, Steven R Lopushinsky
PURPOSE: An accelerated clinical care pathway for solid organ abdominal injuries was implemented at a level one pediatric trauma center. The impact on resource utilization and demonstration of protocol safety was assessed. METHODS: Data were collected retrospectively on patients admitted with blunt abdominal solid organ injuries from 2012 to 2015. Patients were subdivided into pre- and post-protocol groups. Length of hospital stay (LOS) and failure of non-operative treatment were the primary outcomes of interest...
January 29, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28186860/traumatic-rib-injury-patterns-imaging-pitfalls-complications-and-treatment
#10
Brett S Talbot, Christopher P Gange, Apeksha Chaturvedi, Nina Klionsky, Susan K Hobbs, Abhishek Chaturvedi
The ribs are frequently affected by blunt or penetrating injury to the thorax. In the emergency department setting, it is vital for the interpreting radiologist to not only identify the presence of rib injuries but also alert the clinician about organ-specific injury, specific traumatic patterns, and acute rib trauma complications that require emergent attention. Rib injuries can be separated into specific morphologic fracture patterns that include stress, buckle, nondisplaced, displaced, segmental, and pathologic fractures...
February 10, 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28184953/-six%C3%A2-years-later-long-term-follow-up-after-rare-injury-in-childhood
#11
Kai Oliver Jensen, Hatem Alkadhi, Carsten Siewert, Hans Peter Simmen
The present case shows the long-term follow-up of a rare injury due to blunt abdominal trauma in childhood. The patient suffered from a traumatic transsection to the A. iliaca communis, which was restored by the combination of a direct suture with a venous autologous patch. A six-year follow-up when the boy was mature with a height of180 cm showed an unremarkable MRI angiography without any sign of stenosis. Due to the limited number of experiences with this rare injury reported in the literature, there is a lack of consensus on the suture technique and use of patches or grafts...
February 9, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28184357/delayed-splenic-rupture-normal-appearing-spleen-on-the-initial-multidetector-computed-tomography-mdct-can-sometimes-be-misleading
#12
Alireza Hamidian Jahromi, Matias Migliaro, Melisa Romano, Guillermo Sangster
INTRODUCTION: Delayed splenic rupture (DSR) is an unusual outcome following blunt abdominal trauma. Although DSR is defined as bleeding more than 48 hours after blunt trauma in a previously hemodynamically stable patient, a review of the reported cases in the literature shows that in almost all of the cases the initial CT imaging revealed some form of damage to the spleen. CASE PRESENTATION: Here we describe an extremely rare condition in a case that presented with a DSR following blunt trauma and had a normal appearing spleen in the initial post trauma MDCT scan...
November 2016: Trauma Monthly
https://www.readbyqxmd.com/read/28180986/what-are-the-differences-in-injury-patterns-of-young-and-elderly-traffic-accident-fatalities-considering-death-on-scene-and-death-in-hospital
#13
Daniela Heinrich, Christopher Holzmann, Anja Wagner, Anja Fischer, Roman Pfeifer, Matthias Graw, Sylvia Schick
Older traffic participants have higher risks of injury than the population up to 65 years in case of comparable road traffic accidents and further, higher mortality rates at comparable injury severities. Rib fractures as risk factors are currently discussed. However, death on scene is associated with hardly survivable injuries and might not be a matter of neither rib fractures nor age. As 60% of traffic accident fatalities are estimated to die on scene, they are not captured in hospital-based trauma registries and injury patterns remain unknown...
February 8, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28180124/does-a-negative-emergency-celiotomy-exclude-the-possibility-of-significant-diaphragmatic-injury-a-case-report-and-review-of-the-literature
#14
Alireza Hamidian Jahromi, David Pennywell, John T Owings
INTRODUCTION: Diaphragmatic rupture (DR) is an uncommon, potentially serious complication following blunt or penetrating abdominal trauma. Even with a high index of suspicion, the diagnosis of DR can easily be missed for a long period post injury. Delayed or missed diagnosis [delayed diagnosis of diaphragmatic rupture (DDDR)] and delayed diaphragmatic rupture (DDR) are possible explanations in cases where the initial operative exploration fails to show the diaphragmatic damage. CASE PRESENTATION: Here we present a patient with suspected DR that was not seen on initial open abdominal exploration, but was suggested by subsequent serial imaging...
September 2016: Trauma Monthly
https://www.readbyqxmd.com/read/28179708/a-rare-congenital-liver-anomaly-hypoplasia-of-left-hepatic-lobe
#15
Tugrul Ormeci, Secil Telli Erdogan, Asli Ormeci, Cem Aygun
Morphologic anomalies of liver, as opposed to many other visceral organs, are very rare. Hypoplasia or agenesis of left lobe of the liver is defined as the absence of liver tissue on the left side of liver without previous disease or surgery. It is usually an incidental finding revealed by imaging exams or during abdominal surgery. A 44-year-old female patient was admitted to the hospital for abdominal pain and discomfort. Physical examination revealed no specific abnormality. Routine laboratory tests were normal...
December 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28177973/monomicrobial-klebsiella-pneumoniae-necrotizing-fasciitis-with-liver-abscess-a-case-report-and-literature-review
#16
Ching-En Chen, Yu-Chung Shih
BACKGROUND: Necrotizing fasciitis is one of the most life-threatening soft tissue infections and usually follows a major or minor trauma. Published reports regarding single microorganism liver abscess caused by Klebsiella pneumoniae in Taiwan indicate a septic metastasis rate about 12%. Although a hematogenous origin of necrotizing fasciitis from a liver abscess is rare in Taiwan, it remains possible in our clinical practice. CASE PRESENTATION: A 75-year-old man with a history of diabetes and liver abscess had a status of postdrainage 5 years earlier...
February 8, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28168570/early-enteral-nutrition-in-critically-ill-patients-esicm-clinical-practice-guidelines
#17
REVIEW
Annika Reintam Blaser, Joel Starkopf, Waleed Alhazzani, Mette M Berger, Michael P Casaer, Adam M Deane, Sonja Fruhwald, Michael Hiesmayr, Carole Ichai, Stephan M Jakob, Cecilia I Loudet, Manu L N G Malbrain, Juan C Montejo González, Catherine Paugam-Burtz, Martijn Poeze, Jean-Charles Preiser, Pierre Singer, Arthur R H van Zanten, Jan De Waele, Julia Wendon, Jan Wernerman, Tony Whitehouse, Alexander Wilmer, Heleen M Oudemans-van Straaten
PURPOSE: To provide evidence-based guidelines for early enteral nutrition (EEN) during critical illness. METHODS: We aimed to compare EEN vs. early parenteral nutrition (PN) and vs. delayed EN. We defined "early" EN as EN started within 48 h independent of type or amount. We listed, a priori, conditions in which EN is often delayed, and performed systematic reviews in 24 such subtopics. If sufficient evidence was available, we performed meta-analyses; if not, we qualitatively summarized the evidence and based our recommendations on expert opinion...
February 6, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28168326/damage-control-laparotomy-for-abdominal-trauma-in-children
#18
Stephanie F Polites, Elizabeth B Habermann, Amy E Glasgow, Martin D Zielinski
BACKGROUND: Damage control laparotomy (DCL) is not well studied in the pediatric trauma population. The purpose of this study was to develop a surrogate definition of DCL compatible with national and administrative data sources so that the rate and outcomes of DCL in pediatric trauma patients could be determined. METHODS: Using the 2010-2014 National Trauma Data Bank, children ≤18 with an abdominal AIS ≥ 3 who underwent a laparotomy within 3 h of arrival were identified (n = 2989)...
February 6, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28165875/multidetector-ct-of-surgically-proven-blunt-bowel-and-mesenteric-injury
#19
David D B Bates, Michael Wasserman, Anita Malek, Varun Gorantla, Stephan W Anderson, Jorge A Soto, Christina A LeBedis
Blunt traumatic injury is one of the leading causes of morbidity and mortality in the United States. Unintentional injury represents the leading cause of death in the United States for all persons between the ages of 1 and 44 years. In the setting of blunt abdominal trauma, the reported rate of occurrence of bowel and mesenteric injuries ranges from 1% to 5%. Despite the relatively low rate of blunt bowel and mesenteric injury in patients with abdominal and pelvic trauma, delays in diagnosis are associated with increased rates of sepsis, a prolonged course in the intensive care unit, and increased mortality...
February 10, 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28162908/does-bacterial-translocation-influence-the-postoperative-infections-in-splenectomized-patients-after-abdominal-trauma
#20
Mario Schietroma, Beatrice Pessia, Sara Colozzi, Francesco Carlei, Gianfranco Amicucci
BACKGROUND: Some studies suggested that after abdominal trauma, postoperative infections are associated with bacterial translocation, whereas others have not replicated these findings. We have assessed the bacterial translocation and postoperative infections in patients undergoing splenectomy after abdominal trauma, using a very homogeneous study population. METHODS: We consecutively studied, in a prospective observational clinical study, 125 patients who required urgent surgical treatment (splenectomy) following blunt abdominal trauma...
February 2, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
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