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Splenic trauma

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https://www.readbyqxmd.com/read/29321842/splenic-pedicle-control-during-laparoscopic-de-capsulation-of-a-giant-splenic-cyst
#1
Osama Elhardello, Basil J Ammori
Splenic cysts are a rare entity in the Western population and are either true cysts (primary, 25%) or pseudocysts (secondary, 75%) complicating trauma, haemorrhage or infarction. Congenital or simple splenic cysts are the commonest primary cysts and surgery is recommended for cysts larger than 5 cm as these are prone to infection, bleeding or rupture and for symptomatic or complicated cysts. Splenic preservation techniques using the laparoscopic approach are the most prevalent. We present a case of a giant painful simple splenic cyst treated with laparoscopic de-capsulation with application of a new technique for achieving vascular control, whereby control of the splenic pedicle was achieved using a Nylon tape...
January 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29313164/treatment-of-nonocclusive-mesenteric-ischemia-with-type-b-aortic-dissection-using-intra-arterial-catheterization-after-trauma-surgery-case-report
#2
Sho Fujiwara, Yuki Sekine, Ryuichi Nishimura, Kazuya Tadasa, Shukichi Miyazaki
BACKGROUND: Nonocclusive mesenteric ischemia (NOMI) is a mesenteric arterial spasm and intestinal ischemia. This disease is a highly lethal disease because diagnosis and decision of appropriate treatments are often difficult. Operations cannot resolve the spasms and may worsen the situation. However, the safety and effectiveness of catheterization for NOMI with aortic dissection (AD) have not yet been elucidated. Here, we report a successful case of early diagnosis and treatment of NOMI with type B AD involving the superior mesenteric artery (SMA) using the intra-arterial infusion of a vasodilator via the SMA...
January 8, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29291540/open-splenectomy-for-varicella-zoster-induced-spontaneous-splenic-rupture
#3
Mark Christopher Sykes, Bilal Azhar, Laurence John, Salman Bokhari
INTRODUCTION: Here we present a case of atraumatic splenic rupture secondary to varicella infection requiring emergency splenectomy. The presentation was as would be expected for epstein barr virus (EBV) related splenic injury, which is well documented in the literature. Dermatological findings however suggested varicella zoster, and viral serology subsequently confirmed the diagnosis. PRESENTATION OF CASE: A young Romanian male presented to the emergency department with peritonism without preceding trauma...
December 24, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29284921/splenic-localization-of-primary-hydatid-cyst-in-a-27-year-old-sportsman-treated-by-pair-technique-imaging-anatomy-assessment
#4
Dzenan Jahic, Eldan Kapur, Edin Begic, Enver Zerem
Introduction: In this paper, we report our experience with a case of primary hydatid cyst involving only the spleen in a 27-year-old sportsman treated by PAIR technique. Case Report: Five years before, a 27-year-old handball player being admitted to our hospital, it was detected the cyst in his spleen which size was 35 x 30 mm in diameter, by abdominal ultrasound during a systematic examination. There was no pain or any other symptoms at that time. Tests on the presence of echinococcus cysts were negative...
December 2017: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/29261593/non-operative-management-of-abdominal-solid-organ-injuries-following-blunt-trauma-in-adults-results-from-an-international-consensus-conference
#5
Stefania Cimbanassi, Osvaldo Chiara, Ari Leppaniemi, Sharon Henry, Thomas M Scalea, Kathirkamanathan Shanmuganathan, Walter Biffl, Fausto Catena, Luca Ansaloni, Gregorio Tugnoli, Elvio De Blasio, Arturo Chieregato, Giovanni Gordini, Sergio Ribaldi, Maurizio Castriconi, Patrizio Festa, Federico Coccolini, Salomone di Saverio, Antonio Galfano, Massimo Massi, Marilena Celano, Massimiliano Mutignani, Stefano Rausei, Desiree Pantalone, Antonio Rampoldi, Luca Fattori, Stefano Miniello, Sebastian Sgardello, Francesca Bindi, Federica Renzi, Fabrizio Sammartano
BACKGROUND: Non-operative management (NOM) for blunt solid organ injuries has become the standard of care for patients who are hemodynamically stable, without other indications for explorative laparotomy. Our aims were to develop evidence-based guidelines to correctly identify the indications for NOM in adult blunt trauma patient, the best and most appropriate modality for follow-up, and the best techniques to manage complications. METHODS: The literature since 2000 to 2016 was systematically screened according to PRISMA [Preferred Reporting Items for Systematic Reviews and meta-analyses] protocol...
December 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29251706/valproic-acid-induces-pro-survival-transcriptomic-changes-in-swine-subjected-to-traumatic-injury-and-hemorrhagic-shock
#6
Patrick E Georgoff, Vahagn C Nikolian, Gerald Higgins, Kiril Chtraklin, Hassan Eidy, Mohamed H Ghandour, Aaron Williams, Brian Athey, Hasan B Alam
BACKGROUND: Valproic acid (VPA) is a histone deacetylase inhibitor that improves outcomes in large animal models of trauma. However, its protective mechanism of action is not completely understood. We sought to characterize the genetic changes induced by VPA treatment following traumatic injuries. METHODS: Six female Yorkshire swine were subjected to traumatic brain injury (TBI, controlled cortical impact), polytrauma (liver and splenic laceration, rib fracture, rectus crush), and hemorrhagic shock (HS, 40% total blood volume)...
December 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29234730/spontaneous-superior-mesenteric-artery-branch-pseudoaneurysm-a-rare-case-report
#7
Mina Guirgis, Jema Hua Xu, Alar Kaard, Bibombe P Mwipatayi
Background: Visceral arterial pseudoaneurysms (VAPAs) are rare vascular entities with serious consequences. Traditionally, they are associated with trauma, infection, and inflammatory disease, or they can arise as a post-operative complication. Report: An 87 year old man presented with abdominal pain and was found to have a spontaneous VAPA on a computed tomography angiogram. Serial imaging 4 months previously had demonstrated no aneurysm. Between scans, warfarin was changed to apixaban for aortic valve replacement, but he had no other changes to any other medications...
2017: EJVES Short Reports
https://www.readbyqxmd.com/read/29221814/use-of-interventional-radiology-as-initial-hemorrhage-control-to-improve-outcomes-for-potentially-lethal-multiple-blunt-injuries
#8
Hiroyuki Otsuka, Toshiki Sato, Keiji Sakurai, Hiromichi Aoki, Takeshi Yamagiwa, Shinichi Iizuka, Sadaki Inokuchi
INTRODUCTION: Recently, trauma management has been markedly improved with interventional radiology (IVR) and damage-control strategies. However, the indications for its use in hemodynamically unstable patients with severe trauma remains unclear. In some cases, IVR may be more effective than surgery for damage-control hemostasis; however, performing IVR in life-threatening trauma settings is challenging. To address this, we practiced and evaluated a trauma-management system with emergency physicians who trained for both severe trauma management, and techniques of surgery and IVR...
December 6, 2017: Injury
https://www.readbyqxmd.com/read/29204237/pediatric-adrenal-trauma-evaluation-and-follow-up-with-contrast-enhanced-ultrasound-ceus
#9
Vasileios Rafailidis, Annamaria Deganello, Maria E Sellars, Erica Makin, Paul S Sidhu
Adrenal trauma is rarely encountered in the pediatric population, often as a component of multi-organ injury and often presenting with hematoma formation. Contrast-enhanced computed tomography (CECT) is the established imaging modality both for initial evaluation and follow-up of patients with blunt abdominal trauma. In children, radiation exposure should be minimized and alternative imaging strategies are needed. Contrast-enhanced ultrasound (CEUS) has recently been successfully used for evaluation of patients with hepatic, renal and splenic injury...
December 2017: Journal of Ultrasound
https://www.readbyqxmd.com/read/29200102/adult-primary-immune-thrombocytopenia-spleen-histology-findings-and-outcomes-according-to-rituximab-use-based-on-analysis-of-41-cases
#10
Adeline Furudoï, Étienne Rivière, Estibaliz Lazaro, Enio Furudoï, Jean-François Viallard, Marie Parrens
Immune thrombocytopenia (ITP) is an acquired antibody-mediated disease, for which splenectomy remains a curative treatment. We analyzed histology and phenotypes of ITP-splenectomy specimens from 41 adult patients, with different previous ITP-specific treatments, including B-cell-depleting rituximab (RTX) or not, in an attempt to predict splenectomy success or failure on the basis of day 56 postoperative platelet counts. RTX-naive ITP-spleen samples, compared with those from a 20-patient control trauma cohort, contained the following nonspecific, ITP-evocative, white-pulp lesions: follicular helper T-cell (programmed death-1 and inducible T-cell COStimulator) expansion in reactive follicles (P=0...
December 1, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/29182903/total-laparoscopic-splenectomy-for-giant-epidermoid-cyst-a-case-report
#11
P Lobascio, G Carbotta, R Laforgia, S Fedele, M G Sederino, M Minafra, A Delvecchio, F Ferrarese, N Palasciano
INTRODUCTION: Splenic cysts are benign tumors, accidentally detected using US or CT scan. They are classified into true cyst (primary, 25%) and pseudocyst (secondary, 75%). Conventional treatment of splenic cyst, especially giant, symptomatic and complicated has been open or laparoscopic total splenectomy. Recently, partial splenectomy is recommended as well to preserve its hematopoietic function and homeostasis of blood, but it is not considered safe for complications as intra and post operative bleeding...
July 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29169401/treatment-of-splenic-trauma-in-norway-a-retrospective-cohort-study
#12
Trond Dehli, Jorunn Skattum, Bjørn Christensen, Ole-Petter Vinjevoll, Bent-Åge Rolandsen, Christine Gaarder, Pål Aksel Næss, Torben Wisborg
BACKGROUND: Non-operative management of splenic injuries has become the treatment of choice in hemodynamically stable patients over the last decades. The aim of the study is to describe the incidence, initial treatment and early outcome of patients with splenic injuries on a national level. METHODS: All hospitals in Norway admitting trauma patients were invited to participate in the study. The study period was January through December 2013. The hospitals delivered anonymous data on primarily admitted patients with splenic injury...
November 23, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29167946/beaver-tail-liver
#13
REVIEW
Mehmet Haydar Atalar, Kayhan Karakus
Also known as the sliver of liver, beaver tail liver is an anatomic variation of the liver where its left lobe extends laterally to contact and enclose the spleen. Hepatic parenchyma is normal. It may be difficult to distinguish the two organs from each other when both have equal echogenicity or density in ultrasonography and computed tomography. Therefore, it may mimic a splenic trauma or a perisplenic hemorrhage or subcapsular hematoma within the splenic parenchyma.
November 22, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/29079311/the-incidence-of-delayed-splenic-bleeding-in-pediatric-blunt-trauma
#14
David M Notrica, Lois W Sayrs, Amina Bhatia, Robert W Letton, Adam Alder, Shawn St Peter, Todd A Ponsky, James W Eubanks, Karla A Lawson, Daniel J Ostlie, David W Tuggle, Nilda M Garcia, R Todd Maxson, Charles Leys, Cynthia Greenwell
BACKGROUND: One of the concerns associated with nonoperative management of splenic injury in children has been delayed splenic bleed (DSB) after a period of hemostasis. This study evaluates the incidence of DSB from a multicenter 3-year prospective study of blunt splenic injuries (BSI). METHODS: A 3-year prospective study was done to evaluate nonoperative management of pediatric (≤18years) BSI presenting to one of 10 pediatric trauma centers. Patients were tracked at 14 and 60days...
October 8, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29077678/is-it-safe-nonoperative-management-of-blunt-splenic-injuries-in-geriatric-trauma-patients
#15
Marc D Trust, Pedro Teixeira, Lawrence Brown, Sadia Ali, Ben Coopwood, Jayson Aydelotte, Carlos V R Brown
BACKGROUND: Due to increased failure rates of non-operative management (NOM) of blunt splenic injuries (BSI) in the geriatric population, dogma dictated that this management was unacceptable. Recently, there has been an increased use of this treatment strategy in the geriatric population. However, published data assessing the safety of NOM of BSI in this population is conflicting and well-powered multicenter data is lacking. METHODS: We performed a retrospective analysis of data from the National Trauma Data Bank (NTDB) from 2014 and identified young (age < 65) and geriatric (age ≥ 65) patients with a BSI...
October 25, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29068875/the-role-of-splenic-angioembolization-as-an-adjunct-to-nonoperative-management-of-blunt-splenic-injuries-a-systematic-review-and-meta-analysis
#16
REVIEW
James Charles Ian Crichton, Kamil Naidoo, Barbaros Yet, Susan I Brundage, Zane Perkins
BACKGROUND: Nonoperative management (NOM) of hemodynamically normal patients with blunt splenic injury (BSI) is the standard of care. Guidelines recommend additional splenic angioembolization (SAE) in patients with American Association for the Surgery of Trauma (AAST) Grade IV and Grade V BSI, but the role of SAE in Grade III injuries is unclear and controversial. The aim of this systematic review was to compare the safety and effectiveness of SAE as an adjunct to NOM versus NOM alone in adults with BSI...
November 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29040205/spleen-preserving-distal-pancreatectomy-in-trauma
#17
Morgan Schellenberg, Kenji Inaba, Vincent Cheng, James M Bardes, Lydia Lam, Elizabeth Benjamin, Kazuhide Matsushima, Demetrios Demetriades
BACKGROUND: Traumatic injuries to the distal pancreas are infrequent. Universally accepted recommendations about the need for routine splenectomy with distal pancreatectomy do not exist. The aims of this study were to compare outcomes after distal pancreatectomy and splenectomy vs spleen-preserving distal pancreatectomy, and to define the appropriate patient population for splenic preservation. METHODS: All patients who underwent distal pancreatectomy (01/01/2007-12/31/2014) were identified from the NTDB...
October 16, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28993671/mdscs-are-induced-after-experimental-blunt-chest-trauma-and-subsequently-alter-antigen-specific-t-cell-responses
#18
Yvonne Hüsecken, Sylvia Muche, Monika Kustermann, Malena Klingspor, Annette Palmer, Sonja Braumüller, Markus Huber-Lang, Klaus-Michael Debatin, Gudrun Strauss
Severe blunt chest trauma (TxT) induces a strong inflammatory response with posttraumatic immune suppression pointing to an impaired adaptive immune response. Since CD11b(+)Gr-1(+)-expressing myeloid-derived suppressor cells (MDSCs) are induced after inflammation and suppress T cell responses, MDSC induction and their impact on T cell functions was analysed in an experimental TxT model. MDSCs were induced preferentially in the lung until 24 hours after TxT. Although MDSC numbers were only faintly increased in the spleen, splenic MDSCs isolated after TxT strongly inhibited alloantigen-induced T cell proliferation in vitro...
October 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28984337/primary-splenic-pregnancy-a-rare-but-imperative-cause-of-hemoperitoneum-case-report-and-review-of-literature
#19
Ruchi Rathore, Shilpi Shilpi, Ratna Chopra, Namrata Nargotra
Primary splenic pregnancy is an extremely rare form of extratubal ectopic pregnancy. These cases often cause splenic rupture in very early course of their gestation thereby presenting with hemoperitoneum in emergencies. Owing to the higher risk of exsanguination and death caused by hemoperitoneum, it is essential to diagnose these cases for proper management and better prognosis of the patients. We present the case of a 23-year-old female, gravida 2, para 1, live issue 1 presenting to the emergency outpatient department with acute abdomen and hemoperitoneum...
October 6, 2017: Türk Patoloji Dergisi
https://www.readbyqxmd.com/read/28981490/ten-year-experience-of-splenic-trauma-in-new-zealand-the-rise-of-non-operative-management
#20
Yassar Alamri, Dana Moon, Damien Ah Yen, Chris Wakeman, Tim Eglinton, Frank Frizelle
AIM: The aim of this study was to describe the demographics, mechanisms of injury, management and outcomes in patients who suffered splenic trauma in Christchurch, New Zealand. METHODS: A retrospective study included all splenic injury patients admitted to Christchurch Public Hospital between January 2005 and August 2015. RESULTS: A total of 238 patients were included, with a median age of 26 years (4-88.7). Of these, 235 patients had blunt injuries...
October 6, 2017: New Zealand Medical Journal
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