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https://www.readbyqxmd.com/read/29225120/retained-bullet-in-the-kidney-imaging-and-conservative-management
#1
Guglielmo Mantica, Stephan Kruger, Hilgard Ackermann, Pieter V Spies, Farzana Cassim, Zamira Keyser, Carlo Terrone, André van der Merwe
Renal gunshot wounds resulting in a grade IV injury (AAST) should be explored only if they involve the hilum or if there are signs of suspected renal pelvis or ureteral laceration, active haemorrhage, peritonitis or hemodynamically unstable patients.1 However, due to the paucity of cases reported in the literature, it is not clear what the best management of patients with a retained bullet is, which have been traditionally treated with surgical retrieval in other organs. We present the radiological findings and a clinical case summary of a patient with Grade IV kidney injury and retained bullet managed conservatively...
December 7, 2017: Urology
https://www.readbyqxmd.com/read/29210725/airway-management-in-a-patient-with-tracheal-disruption-due-to-penetrating-neck-trauma-with-hollow-point-ammunition-a-case-report
#2
Angela M Johnson, James L Hill, Dave J Zagorski, Joseph M McClain, Nicole C Maronian
Rapid sequence induction and intubation was performed for a patient in respiratory distress after a gunshot wound to the neck. Resistance was noted distal to vocal cords. With a bronchoscope unavailable, the endotracheal tube was advanced with a corkscrew maneuver. Subcutaneous emphysema had developed. The endotracheal tube was advanced into the right mainstem with adequate ventilation. Imaging illustrated tracheoesophageal injury. The patient was emergently explored. An intraluminal bullet was removed, lateral wall tracheal defect was repaired, and a tracheostomy was placed...
November 27, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29203201/combat-related-acetabular-fractures-outcomes-of-open-versus-closed-injuries
#3
Richard L Purcell, Michael A Donohue, Sameer K Saxena, Wade T Gordon, Louis L Lewandowski
INTRODUCTION: Since the onset of the Global War on Terror close to 50,000 United States service members have been injured in combat, many of these injuries would have previously been fatal. Among these injuries, open acetabular fractures are at an increased number due to the high percentage of penetrating injuries such as high velocity gunshot wounds and blast injuries. These injuries lead to a greater degree of contamination, and more severe associated injuries. There is a significantly smaller proportion of the classic blunt trauma mechanism typically seen in civilian trauma...
December 1, 2017: Injury
https://www.readbyqxmd.com/read/29194100/hematomas-in-tiger-territory-an-endovascular-alternative-to-wading-in
#4
Desarom Teso, Benjamin J Rogoway, Yolanda L Vea, Judson E Threlkeld, George R Dulabon, Riyad C Karmy-Jones
A 26-year-old man presented with gunshot wound to the epigastrium. At surgery, he was hemodynamically stable and had a tense hematoma with thrill in zone 2 (right side) and porta triad. After liver injury was controlled, he underwent percutaneous stenting of a renal artery-vena cava fistula and the hepatic artery injury was followed. Historically, penetrating injury to zone 2 has mandated operative exploration. However, with the advent of endovascular options, in stable patients, catheter-based options offer a reasonable alternative with less risk of blood loss and possible nephrectomy...
November 30, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29191407/occupational-outcomes-following-combat-related-gunshot-injury-cohort-study
#5
Matthew D Laughlin, Philip J Belmont, Paul J Lanier, Julia O Bader, Brian R Waterman, Andrew J Schoenfeld
BACKGROUND: The long-term impact of gun violence on physical function and occupational disability remains poorly explored. We sought to examine the effect of combat-related gunshot injury on work capacity within a cohort of military servicemembers and identify clinical characteristics that influence the capacity to return to work. METHODS: A query was performed to identify all servicemembers injured by gunshot in the years 2005-2009. These soldiers were then followed for a period up to the end of 2014 in order to identify those separated from service due to an inability to perform military duties as a result of their injury...
November 27, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29183519/abdominal-trauma-revisited
#6
REVIEW
David V Feliciano
Although abdominal trauma has been described since antiquity, formal laparotomies for trauma were not performed until the 1800s. Even with the introduction of general anesthesia in the United States during the years 1842 to 1846, laparotomies for abdominal trauma were not performed during the Civil War. The first laparotomy for an abdominal gunshot wound in the United States was finally performed in New York City in 1884. An aggressive operative approach to all forms of abdominal trauma till the establishment of formal trauma centers (where data were analyzed) resulted in extraordinarily high rates of nontherapeutic laparotomies from the 1880s to the 1960s...
November 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29177179/endovascular-management-of-a-penetrating-zone-iii-retroperitoneal-gunshot-wound-injury-a-case-report
#7
Saptarshi Biswas, Boris Hristov
Traumatic iliac vessels injuries secondary to gunshot wound can often be fatal at the scene. One of the intriguing complications of vascular injuries is arteriovenous fistula. If the patient survives, these lesions may often not be diagnosed on first evaluation and patients may present with clinical signs and symptoms years later. Open surgical repair can have prohibitive morbidity and mortality and endovascular techniques, an effective treatment alternative, can interrupt the abnormal vascular communication and preserve artery vein patency...
October 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/29164295/the-economic-and-social-burden-of-traumatic-injuries-evidence-from-a-trauma-hospital-in-port-au-prince-haiti
#8
Christopher Zuraik, John Sampalis, Alexa Brierre
INTRODUCTION: The cost of traumatic injury is unknown in Haiti. This study aims to examine the burden of traumatic injury of patients treated and evaluated at a trauma hospital in the capital city of Port-au-Prince. METHODS: A retrospective cross-sectional chart review study was conducted at the Hospital Bernard Mevs Project Medishare for all patients evaluated for traumatic injury from December 2015 to January 2016, as described elsewhere (Zuraik and Sampalis in World J Surg, https://doi...
November 21, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29161213/laparoscopic-management-of-penetrating-thoracoabdominal-trauma
#9
Megan C Prunty, Siddharth Kudav, Jacob A Quick
BACKGROUND: Traumatic thoracoabdominal injuries can involve multiple organs and multiple cavities, which increases the complexity of surgical management. Traditionally, these injuries required laparotomy and thoracotomy. However, minimally invasive intervention may be reasonable for stable patients. MATERIALS AND METHODS: We present a case of a thoracoabdominal gunshot wound resulting in multiorgan, multicavity injury to the lung, diaphragm, and liver. We performed hepatorrhaphy and diaphragm repair, and addressed a retained hemothorax through a transabdominal laparoscopic approach...
November 21, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29155110/delayed-traumatic-aortic-pseudoaneurysm-formation-causing-vertebral-body-erosion-and-back-pain-case-report-and-literature-review
#10
Justin M Cappuzzo, Kathleen E Knudson, Shawn Sarin, Joseph Babrowicz, Abraham Cherrick, Jonathan H Sherman
BACKGROUND: Aortic pseudoaneurysms are a rare cause of chronic back pain, usually due to compression of adjacent neurovasculature. It is uncommon for patients with pseudoaneurysms of the abdominal aorta to present in a delayed fashion after initial traumatic injury. CASE DESCRIPTION: We present an unusual case of delayed pseudoaneurysm formation, with subsequent erosion into the adjacent L1 vertebral body. This pseudoaneurysm was secondary to a gunshot wound with retained ballistic fragment that occurred 27 years prior...
November 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29119221/preparing-japanese-surgeons-for-potential-mass-casualty-situations-will-require-innovative-and-systematic-programs
#11
H Uchino, V Y Kong, J L Bruce, G V Oosthuizen, W Bekker, G L Laing, D L Clarke
INTRODUCTION: The ongoing state of global geo-political instability means that it is prudent to prepare civilian surgeons to manage major military-type trauma. Japan has enjoyed a prolonged period of peace and consequently it is unlikely that surgeons will have been exposed to a sufficient volume of cases. This study reviews the state of trauma training and preparedness in Japan and reviews the trauma workload of a major Japanese emergency medical center and compared with a major South African trauma center with the intention of quantifying and comparing the time needed to gain adequate exposure to major trauma at the two centers...
November 8, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29106889/functional-anatomic-computer-engineered-surgery-protocol-for-the-management-of-self-inflicted-gunshot-wounds-to-the-maxillofacial-skeleton
#12
Baber Khatib, Karl Cuddy, Allen Cheng, Ashish Patel, Felix Sim, Melissa Amundson, Savannah Gelesko, Tuan Bui, Eric J Dierks, R Bryan Bell
PURPOSE: Virtual surgical planning (VSP) is an indispensable aid in craniomaxillofacial reconstruction, yet no protocol is established in facial gunshot wounds. We review our experience with computer-aided reconstruction of self-inflicted facial gunshot wounds (SIGSW'S) and propose a protocol for the staged repair. METHODS: A retrospective case series enrolling patients with SIGSW's managed with the Functional Anatomic Computer Engineered Surgical protocol (FACES) was implemented...
October 14, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29099696/treatment-of-duodenal-injuries-and-complications-after-surgery-case-reports
#13
Z Beriashvili, M Gurgenidze
A 28-year-old male patient came to Surgical Department 15.07.2003 after a gunshot wound. An emergency operation was performed. Among the other damages of different part of intestinum damage of the anterior wall of the second anatomical part of the duodenum was diagnosed intraoperatively. The size of the damaged area was 3×1 sm. The doudenal wound was sutured with two layers after updating the edges. On the fifth postoperative day the wound leakage was detected. Later the giant sizes of duodenal fistula was formed...
October 2017: Georgian Medical News
https://www.readbyqxmd.com/read/29082822/endovascular-treatment-of-penetrating-arterial-trauma-with-stent-grafts
#14
Rodrigo Bruno Biagioni, Marcelo Calil Burihan, Felipe Nasser, Luisa Ciucci Biagioni, José Carlos Ingrund
BACKGROUND: The endovascular management of arterial injuries has resulted in reduced operating time, blood loss, hospital mortality, lower incidence of sepsis, and decrease in mortality rates. For penetrating trauma, however, the benefits of endovascular therapy are questionable. PATIENTS AND METHODS: Data were obtained by retrospective analysis of electronic medical records. All patients with vascular trauma seeking care at our institution from January 2010 to December 2015 were reviewed...
October 30, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/29078894/the-utility-of-presacral-drainage-in-penetrating-rectal-injuries-in-adult-and-pediatric-patients
#15
Kate B Savoie, Thomas M Beazley, Brent Cleveland, Sina Khaneki, Troy A Markel, Peter M Hammer, Stephanie Savage, Regan F Williams
BACKGROUND: With changing weaponry associated with injuries in civilian trauma, there is no clinical census on the utility of presacral drainage (PSD) in penetrating rectal injuries (PRIs), particularly in pediatric patients. METHODS: Patients with PRI from July 2004-June 2014 treated at two free-standing children's hospitals and two adult level 1 trauma centers were compared by age (pediatric patients ≤16 years) and PSD. A stratified analysis was performed based on age...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29053544/the-correlation-between-the-ota-ao-classification-system-and-compartment-syndrome-in-both-bone-forearm-fractures
#16
Thomas S Auld, John S Hwang, Nicholas Stekas, Peter D Gibson, Michael S Sirkin, Mark C Reilly, Mark R Adams
OBJECTIVE: To evaluate the efficacy of using the Orthopaedic Trauma Association (OTA/AO) classification for both bone forearm fractures in predicting compartment syndrome. DESIGN: Retrospective cohort. SETTING: Level 1 Academic Trauma Center. PATIENTS/PARTICIPANTS: One hundred fifty-one patients 18 years of age and older, with both bone forearm fractures diagnosed from 2001 to 2016 were categorized based on the OTA/AO classification...
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29050837/forensic-patients-in-the-emergency-department-who-are-they-and-how-should-we-care-for-them
#17
Celia J Filmalter, T Heyns, R Ferreira
BACKGROUND: Patients who suffer violent, crime related injuries are likely to seek medical assistance in emergency departments. Forensic patients may not disclose the cause of their injuries leading to the impairment of evidence. We explored healthcare providers' perceptions of forensic patients and how they should be cared for. METHOD: The perceptions of physicians and nurses regarding the profiles and care of forensic patients were explored in three urban emergency departments...
October 16, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/29025455/the-burden-of-gunshot-injuries-on-orthopaedic-healthcare-resources-in-south-africa
#18
Case Martin, Gerhard Thiart, Graham McCollum, Stephen Roche, Sithombo Maqungo
BACKGROUND: Injuries inflicted by gunshot wounds (GSWs) are an immense burden on the South African (SA) healthcare system. In 2005, Allard and Burch estimated SA state hospitals treated approximately 127 000 firearm victims annually and concluded that the cost of treating an abdominal GSW was approximately USD1 467 per patient. While the annual number of GSW injuries has decreased over the past decade, an estimated 54 870 firearm-related injuries occurred in SA in 2012. No study has estimated the burden of these GSWs from an orthopaedic perspective...
June 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29022789/the-impact-of-mechanism-on-the-management-and-outcome-of-penetrating-colonic-trauma
#19
G V Oosthuizen, V Y Kong, T Estherhuizen, J L Bruce, G L Laing, J J Odendaal, D L Clarke
Introduction In light of continuing controversy surrounding the management of penetrating colonic injuries, we set out to compare the outcome of penetrating colonic trauma according to whether the mechanism of injury was a stab wound or a gunshot wound. Methods Our trauma registry was interrogated for the 5-year period from January 2012 to December 2016. All patients over the age of 18 years with penetrating trauma (stab or gunshot) and with intraoperatively proven colonic injury were reviewed. Details of the colonic and concurrent abdominal injuries were recorded, together with the operative management strategy...
September 15, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29022788/developing-a-simplified-clinical-prediction-score-for-mortality-in-patients-with-cerebral-gunshot-wounds-the-maritzburg-score
#20
V Y Kong, J Odendaal, B Sartorius, D L Clarke, J L Bruce, G L Laing, T Esterhuizen
Introduction Cerebral gunshot wounds are highly lethal and literature on the clinical scores for mortality prediction is limited. Materials and methods A retrospective study was undertaken over a 5-year period at the Pietermaritzburg Metropolitan Trauma Service in South Africa. A simplified clinical prediction score was developed based on clinical and/or physiological variables readily available in the resuscitation room. Results A total of 102 patients were included; 92% (94/102) were male and the mean age was 29 years; 22% (22/102) died during the admission...
September 15, 2017: Annals of the Royal College of Surgeons of England
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