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https://www.readbyqxmd.com/read/29907210/nonoperative-management-of-penetrating-abdominal-solid-organ-injuries-in-children
#1
Reid Sakamoto, Kazuhide Matsushima, Amory de Roulet, Kristine Beetham, Aaron Strumwasser, Damon Clark, Kenji Inaba, Demetrios Demetriades
BACKGROUND: Nonoperative management (NOM) of penetrating solid organ injuries (SOI) has not been well described in the pediatric population. The objective of this study was to characterize the epidemiology, injury patterns, and factors associated with trial and failure of NOM. METHODS: This is a retrospective cohort analysis of the National Trauma Data Bank for the period of 2007-2014. The study population included patients ≤18 y with penetrating injury to the liver, spleen, or kidney...
August 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29894346/airway-management-of-near-complete-tracheal-transection-by-through-the-wound-intubation-a-case-report
#2
Yuel-Kai Jean, Paul Potnuru, Christian Diez
We present an approach to airway management in a patient with machete injuries culminating in near-complete cricotracheal transection, in addition to a gunshot wound to the neck. Initial airway was established by direct intubation through the cricotracheal wound. Once the airway was secured, a bronchoscopy-guided orotracheal intubation was performed with simultaneous retraction of the cricotracheal airway to optimize the surgical field. This case offers insight into a rarely performed approach to airway management...
June 11, 2018: A&A practice
https://www.readbyqxmd.com/read/29892491/war-related-penile-injuries-in-libya-single-institution-experience
#3
Abdalla M Etabbal, Fathi F Hussain, Mohamed O Benkhadoura, Abdalla M Banni
Objective: To report on our initial experience in the management of war-related penile injuries; proper diagnosis and immediate treatment of penile injuries is essential to gain satisfactory results. Besides treating primary wounds and restoring penile function, the cosmetic result is also an important issue for the surgeon. Patients and methods: The study was conducted in the Department of Urology at Benghazi Medical Center and comprised all patients who presented with a shotgun, gunshot or explosive penile injury between February 2011 and August 2017...
June 2018: Arab Journal of Urology
https://www.readbyqxmd.com/read/29889961/survey-of-casualty-evacuation-missions-conducted-by-the-160th-special-operations-aviation-regiment-during-the-afghanistan-conflict
#4
Theodore T Redman, Kevin E Mayberry, Alejandra G Mora, Brock A Benedict, Elliot M Ross, Julian G Mapp, Russ S Kotwal
BACKGROUND: Historically, documentation of prehospital combat casualty care has been relatively nonexistent. Without documentation, performance improvement of prehospital care and evacuation through data collection, consolidation, and scientific analyses cannot be adequately accomplished. During recent conflicts, prehospital documentation has received increased attention for point-of-injury care as well as for care provided en route on medical evacuation platforms. However, documentation on casualty evacuation (CASEVAC) platforms is still lacking...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/29885914/successful-treatment-of-massive-hemothorax-with-class-iv-shock-using-aortography-with-transcatheter-embolization-of-actively-bleeding-posterior-left-intercostal-arteries-after-penetrating-left-chest-trauma-a-case-for-the-hybrid-or
#5
Carolyn Moore, Golda Kwayisi, Prince Esiobu, Keren A Bashan-Gilzenrat, Leslie R Matthews, Jonathan Nguyen, Nathaniel Moriarty, Michael Liggon, Kahdi Udobi, Assad Taha, Ed Childs, Omar Danner
Hemothorax is a common occurrence after blunt or penetrating injury to the chest. Posterior intercostal vessel hemorrhage as a cause of major intrathoracic bleeding is an infrequent source of massive bleeding. Selective angiography with trans-catheter embolization may provide a minimally invasive and efficient method of controlling bleeding refractory to surgical treatment. PRESENTATION OF CASE: A 19 year-old male sustained a gunshot wound to his left chest with massive hemothorax and refractory hemorrhage...
May 3, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29883641/percutaneous-transjugular-extraction-of-venous-bullet-embolism-to-the-right-ventricle
#6
Jean-Christophe Charniot, Philippe Cluzel, Pascal Leprince, Pierre Demondion
Migration of a bullet to a distant part of the body after a gunshot is rarely observed in the clinical setting furthermore migration to the heart is even rare. There are usually no clear symptoms or signs from migration of a bullet. The case of a 28 years old man with an intracardiac bullet migration, 2 months after a gunshot wound to the right abdomen is presented. We suggest that the bullet migrated along vena cava to the right ventricle. Interventional radiology with a percutaneous transjugular extraction was used to recover this intra cardiac projectile...
June 5, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29877141/civilian-gunshot-wounds-to-the-head-prognostic-factors-affecting-mortality-meta-analysis-of-1774-patients
#7
Georgios A Maragkos, Efstathios Papavassiliou, Martina Stippler, Aristotelis S Filippidis
Civilian gunshot wounds to the head (cGSWH) are devastating, but there is no consensus regarding prognosis and management. Therefore, we conducted a meta-analysis to identify prognostic factors associated with mortality. PubMed, EMBASE, Scopus, Web of Science and Cochrane Library were queried for retrospective cohort studies of isolated cGSWH reporting mortality prognostic factors. MOOSE guidelines were followed. Study quality was assessed using the Newcastle-Ottawa scale. Primary outcome was mortality. Pooled estimates of odds ratios and 95% confidence intervals were derived using random-effects models...
June 7, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29876500/triple-vessel-injury-with-single-penetrating-trauma-to-the-lower-extremity-requiring-popliteal-to-posterior-tibial-artery-bypass
#8
Jaspreet Sandhu, Charles La Punzina, Ravi Kothuru
This is a case report describing the delayed presentation of injury to all three lower extremity infrapopliteal arteries after a 34 year old male sustained multiple gunshot wounds, including one to his left lower extremity. As part of his initial assessment, ankle brachial index was performed and was found to be abnormal. Further work up for this was delayed due to need for emergent trauma laparotomy. After this procedure, more detailed evaluation with CT angiography of the extremity injury was performed...
June 2018: Trauma Case Reports
https://www.readbyqxmd.com/read/29873170/solving-the-mystery-hyalinized-cyst-wall-containing-organism-like-structures-in-a-lung-transplant-donor
#9
Julia Bini Viotti, Matthias Loebe, Nicolas Brozzi, Andre Pinto, Jacques Simkins, Christina M Cloke, Jose F Camargo, Sam Salama, Lilian M Abbo
A 59-year-old man with non-ischemic cardiomyopathy underwent orthotopic heart transplantation. The donor, a 31-year-old male declared brain dead after a gunshot wound to the head, was considered high risk due to history of incarceration, illicit drug use and sex with a HIV positive partner. At organ procurement, the heart, kidneys, pancreas and liver looked grossly normal. A small right lower lobe nodule was noticed, and lung biopsy was performed. Bronchoscopy showed purulent secretions in the right lower lobe...
June 5, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29859153/collaborative-management-of-missile-injury-to-right-ventricle-and-subsequent-pulmonary-embolization
#10
Agustin Sibona, Jason C Smith, Daniel P Srikureja, Rahul Sharma, Carin Mascetti, Anees J Razzouk, David G Rabkin
Pulmonary embolization of a missile is a rare phenomenon. Localization after embolization can be confounding and there is no consensus on management. We report a case of a gunshot wound to the chest with preoperative and initial intraoperative imaging localizing the bullet to the right ventricle but a negative intraoperative exploration of the right-sided cardiac chambers. Intraoperative fluoroscopy allowed for immediate localization of the bullet to the hilum of the left lung with subsequent endovascular retrieval...
May 30, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29847675/a-12-year-analysis-of-nonbattle-injury-among-us-service-members-deployed-to-iraq-and-afghanistan
#11
Tuan D Le, Jennifer M Gurney, Nina S Nnamani, Kirby R Gross, Kevin K Chung, Zsolt T Stockinger, Shawn C Nessen, Anthony E Pusateri, Kevin S Akers
Importance: Nonbattle injury (NBI) among deployed US service members increases the burden on medical systems and results in high rates of attrition, affecting the available force. The possible causes and trends of NBI in the Iraq and Afghanistan wars have, to date, not been comprehensively described. Objectives: To describe NBI among service members deployed to Iraq and Afghanistan, quantify absolute numbers of NBIs and proportion of NBIs within the Department of Defense Trauma Registry, and document the characteristics of this injury category...
May 30, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29844927/delayed-diagnosis-of-traumatic-gunshot-wound-brown-sequard-plus-syndrome-due-to-associated-brachial-plexopathy
#12
Raúl A Rosario-Concepción, Juan Carlos Pérez, Claudia Jiménez, Walter R Frontera, Carmen López-Acevedo
Introduction: Brown-Séquard Syndrome (BSS) is one of the rarest incomplete spinal cord syndromes. The combination of injuries to peripheral nerves and the central nervous system result in an array of symptoms that can result in overlapping clinical presentations and delayed diagnosis. Early detection of spinal cord injury in patients with peripheral nerve injury has been observed to have a positive effect on outcomes. Case presentation: This report discusses the case of a 29-year-old male patient with Brown-Sequard-Plus Syndrome (BSPS) and Brachial Plexopathy (BP) secondary to gunshot wound in the left inferior neck...
2018: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/29843856/a-raised-serum-lactate-level-is-an-independent-predictor-of-in-hospital-mortality-in-patients-with-isolated-cerebral-gunshot-wounds
#13
V Y Kong, R D Weale, G L Laing, J L Bruce, G V Oosthuizen, B Sartorius, P Brysiewicz, D L Clarke
BACKGROUND: Cerebral gunshot wounds (CGSWs) represent a highly lethal form of traumatic brain injury, and triaging these patients is difficult. The prognostic significance of the serum lactate level in the setting of CGSWs is largely unknown. OBJECTIVES: To examine the relationship between elevated serum lactate levels and mortality in patients with isolated CGSWs. METHODS: A retrospective review of the regional trauma registry was undertaken at the Pietermaritzburg Metropolitan Trauma Service, South Africa, over a 5-year period from 1 January 2010 to 31 December 2014...
April 25, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29806813/management-of-intra-abdominal-vascular-injury-in-trauma-laparotomy-a-south-african-experience
#14
Ross Weale, Victor Kong, Vassil Manchev, Wanda Bekker, George Oosthuizen, Petra Brysiewicz, Grant Laing, John Bruce, Damian Clarke
BACKGROUND: Intra-abdominal vascular injury (IAVI) is uncommon but continues to be associated with high mortality rates despite technological advances in the past decades. In light of these ongoing developments, we reviewed our contemporary experience with IAVI in an attempt to clarify and refine our management strategies and the outcome of these patients. METHODS: We retrospectively reviewed the charts of all patients admitted between January 2011 and December 2014 at a major trauma centre in South Africa who were found to have an IAVI during laparotomy for trauma...
June 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29806657/self-inflicted-face-gunshot-injuries-two-case-reports
#15
Rokas Gelažius, David Kasradze, Albinas Gervickas
Self-inflicted gunshot injuries to the head and neck area are challenging cases. Immediate and complex approach is required due to complexity of head and neck anatomy. The extent of injury largely depends on velocity of a rifle and penetrated tissues. Management of these type of patients consist of vital resuscitation, primary wound management, soft and hard tissue reconstruction and rehabilitation. Here we present two cases of self-inflicted gunshot injuries with low and high velocity rifles.
2018: Stomatologija
https://www.readbyqxmd.com/read/29794889/supporting-development-during-military-deployment-and-after-april-2018
#16
Katherine A Trier, Demetra Pappas, Bryan Bovitz, Marilyn Augustyn
Ryan is a 6-year-old child new to your primary care practice after relocating from out of state with his father and younger sister. Ryan's grandmother recently expressed concerns about Ryan's social skills and behavior. He was subsequently diagnosed by a developmental and behavioral pediatrician with autism spectrum disorder, global developmental delay, and attention deficit hyperactivity disorder. At your first visit with Ryan, his father provides the following history: When Ryan was 3 years old, he was living with his mother and infant sister while his father was serving his fourth tour of duty with the marines in Afghanistan...
May 22, 2018: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/29787545/recent-advances-in-austere-combat-surgery-use-of-aortic-balloon-occlusion-as-well-as-blood-challenges-by-special-operations-medical-forces-in-recent-combat-operations
#17
D Marc Northern, Justin D Manley, Regan Lyon, Daniel Farber, Benjamin J Mitchell, Kristopher J Filak, Jonathan Lundy, Joe J DuBose, Todd E Rasmussen, John B Holcomb
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) for control of non-compressible torso hemorrhage is a technology that is increasingly being utilized in the combat casualty setting. Its use in the resource restricted environment holds potential to improve hemorrhage control, decrease blood product utilization, decrease morbidity, and improve combat mortality. The objective of this report is to present the single largest series of REBOA use on severely injured combat casualties...
April 30, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29787543/using-clinical-analysis-to-classify-30-day-trauma-readmissions
#18
Sarah K West, Michael ʼShayʼ OʼMara, M Chance Spalding
BACKGROUND: Unplanned hospital readmissions are common across specialties. Descriptive readmission studies commonly query large administrative databases, which some speculate lack clinical granularity. This article provides the framework for a process improvement initiative aimed at identifying clinically meaningful reasons for trauma readmission. Our study hypothesizes an expected difference between the clinically abstracted reasons for readmission and those documented by the data processing staff in the trauma registry, and that those differences will be the starting point to target performance improvement...
April 30, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29785695/differences-in-characteristics-and-outcome-of-patients-with-penetrating-injuries-in-the-usa-and-the-netherlands-a-multi-institutional-comparison
#19
Suzan Dijkink, Pieta Krijnen, Aglaia Hage, Gwendolyn M Van der Wilden, George Kasotakis, Dennis den Hartog, Ali Salim, J Carel Goslings, Frank W Bloemers, Steven J Rhemrev, David R King, George C Velmahos, Inger B Schipper
INTRODUCTION: The incidence and nature of penetrating injuries differ between countries. The aim of this study was to analyze characteristics and clinical outcomes of patients with penetrating injuries treated at urban Level-1 trauma centers in the USA (USTC) and the Netherlands (NLTC). METHODS: In this retrospective cohort study, 1331 adult patients (470 from five NLTC and 861 from three USTC) with truncal penetrating injuries admitted between July 2011 and December 2014 were included...
May 21, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29778274/outcomes-of-tibia-shaft-fractures-caused-by-low-energy-gunshot-wounds
#20
Charles A Su, Mai P Nguyen, Jeffrey A O'Donnell, Heather A Vallier
BACKGROUND: The purpose of this project was to compare the rates of infections, nonunions, malunions, and secondary operations in tibia fractures resultant from low energy GSWs versus those seen in open and closed tibia fractures resultant from blunt trauma. A secondary objective was to assess the utility of using the traditional Gustilo-Anderson classification system for open fractures to describe fractures secondary to low energy GSW. METHODS: A retrospective review of 327 patients with tibia shaft fractures was conducted at our level I trauma center...
May 16, 2018: Injury
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