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Splenic trauma

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https://www.readbyqxmd.com/read/29079311/the-incidence-of-delayed-splenic-bleeding-in-pediatric-blunt-trauma
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
https://www.readbyqxmd.com/read/28942415/confusion-and-abdominal-symptoms-following-a-rugby-tackle
#8
Demetris Ioannides, Madeleine Davies, Stefan Kluzek
A 19-year-old man was sent to the emergency department following a pitch-side assessment for suspected concussion, unexplained upper abdominal tenderness and vomiting, following a high-impact tackle during a rugby match. A Focussed Assessment with Sonography for Trauma (FAST) scan performed in the emergency department suggested intra-abdominal free fluid, and subsequent head and abdominal CT imaging showed no intracranial lesion but confirmed a significant haemoperitoneum due to large splenic tear and bleeding...
September 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28929807/splenic-artery-embolization-in-blunt-trauma-a-single-center-retrospective-comparison-of-the-use-of-gelatin-sponge-versus-coils
#9
Pasteur Rasuli, Bardia Moosavi, Gordon J French, William Petrcich, Ian Hammond
OBJECTIVE: The purpose of this study was to compare the efficacy of gelatin sponge with that of coils for splenic artery embolization in the treatment of blunt splenic injury. MATERIALS AND METHODS: A single-center retrospective review was performed with the records of 63 patients (45 men, 18 women; mean age, 45.5 years; range, 16-84 years) with blunt splenic injury treated at a tertiary care trauma center by splenic artery embolization with gelatin sponge (n = 30 patients) or metallic coils (n = 33 patients) between 2005 and 2014...
September 20, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28928924/giant-pulmonary-teratoma-with-huge-splenic-lymphangiomatosis-a-very-rare-case
#10
Hemail M Alsubaie, Khaled M Alsubaie, Mohammed Eid Mahfouz
Teratomas are tumors composed of tissues derived from more than one germ cell line. They manifested with a great variety of clinical and radiological features. We report a case of a giant left hemithorax teratoma in a female with huge spleen tumor and review the relevant literature. A 38-year-old female with progressively aggravating dyspnea at rest from a mild trauma. Absent breath sounds on the left side. There was splenomegaly. Computed tomography scan revealed a huge mass (20 × 15 × 18 cm), containing elements of heterogeneous density in the left hemithorax...
September 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28910356/recent-trends-in-30-day-mortality-in-patients-with-blunt-splenic-injury-a-nationwide-trauma-database-study-in-japan
#11
Chie Tanaka, Takashi Tagami, Hisashi Matsumoto, Kiyoshi Matsuda, Shiei Kim, Yuta Moroe, Reo Fukuda, Kyoko Unemoto, Hiroyuki Yokota
BACKGROUND: Splenic injury frequently occurs after blunt abdominal trauma; however, limited epidemiological data regarding mortality are available. We aimed to investigate mortality rate trends after blunt splenic injury in Japan. METHODS: We retrospectively identified 1,721 adults with blunt splenic injury (American Association for the Surgery of Trauma splenic injury scale grades III-V) from the 2004-2014 Japan Trauma Data Bank. We grouped the records of these patients into 3 time phases: phase I (2004-2008), phase II (2009-2012), and phase III (2013-2014)...
2017: PloS One
https://www.readbyqxmd.com/read/28898314/-associated-factors-to-non-operative-management-failure-of-hepatic-and-splenic-lesions-secondary-to-blunt-abdominal-trauma-in-children
#12
Adriana Echavarria Medina, Carlos Hernando Morales Uribe, Luis Guillermo Echavarria R, Viviana María Vélez Marín, Jorge Alberto Martínez Montoya, David Fernando Aguillón
INTRODUCTION: The non operative management (NOM) is the standard management of splenic and liver blunt trauma in pediatric patients.Hemodynamic instability and massive transfusions have been identified as management failures. Few studies evaluate whether there exist factors allowing anticipation of these events. The objective was to identify factors associated with the failure of NOM in splenic and liver injuries for blunt abdominal trauma. PATIENTS AND METHOD: Retrospective analysis between 2007-2015 of patients admitted to the pediatric surgery at University Hospital Saint Vincent Foundation with liver trauma and/or closed Spleen...
2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28886723/pancreatic-injury-in-children-a-case-report-and-review-of-the-literature
#13
Fayza Haider, Mohammed Amin Al Awadhi, Eizat Abrar, Mooza Al Dossari, Hasan Isa, Husain Nasser, Hakima Al Hashimi, Sharif Al Arayedh
BACKGROUND: Trauma is the main cause of morbidity and mortality in the pediatric population. Blunt trauma to the abdomen accounts for the majority of abdominal injuries in children. Pancreatic injury, although uncommon (2 to 9%), is the fourth most common solid organ injury. Unlike other solid organ injuries, pancreatic trauma may be subtle and difficult to diagnose. Computed tomography currently is the imaging modality of choice. As the incidence of pancreatic injury in children sustaining blunt abdominal trauma is low, management remains a challenge...
September 9, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28867641/a-comparison-of-the-management-of-blunt-splenic-injury-in-children-and-young-people-a-new-south-wales-population-based-retrospective-study
#14
Susan E Adams, Andrew Holland, Julie Brown
The importance and safety of non-operative management (NOM) of Blunt Splenic Injury (BSI) has been established in children and adults over recent decades. However, studies have shown higher operation rates in adults. There is international evidence that when children are managed in adult centres, operation rates are higher while adolescents in paediatric centres, are operated on in line with paediatric guidelines. This difference between children and young adults, and the factors responsible, have not been examined in New South Wales (NSW)...
August 14, 2017: Injury
https://www.readbyqxmd.com/read/28843715/safety-and-efficacy-of-angioembolisation-followed-by-endoscopic-ultrasound-guided-transmural-drainage-for-pancreatic-fluid-collections-associated-with-arterial-pseudoaneurysm
#15
Surinder S Rana, Amit Kumar, Anupam Lal, Ravi Sharma, Mandeep Kang, Ujjwal Gorsi, Rajesh Gupta
BACKGROUND AND AIMS: Arterial pseudoaneurysms associated with pancreatic fluid collections (PFC's) are serious complication of pancreatitis. There is insufficient data on safety of endoscopic ultrasound (EUS) guided drainage in these patients. AIM: To retrospectively analyze results of combination of angioembolisation followed by EUS guided transmural drainage of PFC's associated with pseudoaneurysms. METHODS: Retrospective analysis of data base of eight patients (all males; mean age: 36...
September 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28832081/primary-splenic-pregnancy-a-rare-but-imperative-cause-of-hemoperitoneum-case-report-and-review-of-literature
#16
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...
2017: Türk Patoloji Dergisi
https://www.readbyqxmd.com/read/28828034/splenic-trauma-wses-classification-and-guidelines-for-adult-and-pediatric-patients
#17
REVIEW
Federico Coccolini, Giulia Montori, Fausto Catena, Yoram Kluger, Walter Biffl, Ernest E Moore, Viktor Reva, Camilla Bing, Miklosh Bala, Paola Fugazzola, Hany Bahouth, Ingo Marzi, George Velmahos, Rao Ivatury, Kjetil Soreide, Tal Horer, Richard Ten Broek, Bruno M Pereira, Gustavo P Fraga, Kenji Inaba, Joseph Kashuk, Neil Parry, Peter T Masiakos, Konstantinos S Mylonas, Andrew Kirkpatrick, Fikri Abu-Zidan, Carlos Augusto Gomes, Simone Vasilij Benatti, Noel Naidoo, Francesco Salvetti, Stefano Maccatrozzo, Vanni Agnoletti, Emiliano Gamberini, Leonardo Solaini, Antonio Costanzo, Andrea Celotti, Matteo Tomasoni, Vladimir Khokha, Catherine Arvieux, Lena Napolitano, Lauri Handolin, Michele Pisano, Stefano Magnone, David A Spain, Marc de Moya, Kimberly A Davis, Nicola De Angelis, Ari Leppaniemi, Paula Ferrada, Rifat Latifi, David Costa Navarro, Yashuiro Otomo, Raul Coimbra, Ronald V Maier, Frederick Moore, Sandro Rizoli, Boris Sakakushev, Joseph M Galante, Osvaldo Chiara, Stefania Cimbanassi, Alain Chichom Mefire, Dieter Weber, Marco Ceresoli, Andrew B Peitzman, Liban Wehlie, Massimo Sartelli, Salomone Di Saverio, Luca Ansaloni
Spleen injuries are among the most frequent trauma-related injuries. At present, they are classified according to the anatomy of the injury. The optimal treatment strategy, however, should keep into consideration the hemodynamic status, the anatomic derangement, and the associated injuries. The management of splenic trauma patients aims to restore the homeostasis and the normal physiopathology especially considering the modern tools for bleeding management. Thus, the management of splenic trauma should be ultimately multidisciplinary and based on the physiology of the patient, the anatomy of the injury, and the associated lesions...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28790101/splenic-rupture-following-synchronised-direct-current-cardioversion
#18
Nicholas Kaufman, David Ferraro
Atraumatic rupture of the normal spleen is a rare entity. Often, a triggering factor or minor physical event can be ascribed as the aetiology for rupture, including coughing, vomiting or minor medical procedures not involving the spleen. A 65-year-old man who was hospitalised for eosinophilic pneumonia developed haemodynamically unstable atrial flutter that necessitated urgent synchronised direct current cardioversion (DCCV). Two hours after successful cardioversion, he developed signs of an acute abdomen with free intraperitoneal fluid identified on bedside ultrasonography...
August 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28779968/evolution-of-the-treatment-of-splenic-injuries-from-surgery-to-non-operative-management
#19
Patrizio Petrone, María Fernanda Anduaga Peña, María José Servide Staffolani, Collin Brathwaite, Alexander Axelrad, José Ceballos Esparragón
The spleen is one of the most frequently injured organs in blunt abdominal trauma. In the past decades, the treatment of patients with blunt splenic injury has shifted from operative to non-operative management. The knowledge of physiology and immunology of the spleen have been the main reasons to develop techniques for splenic salvage. The advances in high-resolution imaging techniques, as well as less invasive procedures, including angiography and angioembolization, have allowed a higher rate of success in the non-operative management...
October 2017: Cirugía Española
https://www.readbyqxmd.com/read/28769999/non-operative-management-for-penetrating-splenic-trauma-how-far-can-we-go-to-save-splenic-function
#20
Roy Spijkerman, Michel Paul Johan Teuben, Fatima Hoosain, Liezel Phyllis Taylor, Timothy Craig Hardcastle, Taco Johan Blokhuis, Brian Leigh Warren, Luke Petrus Hendrikus Leenen
BACKGROUND: Selective non-operative management (NOM) for the treatment of blunt splenic trauma is safe. Currently, the feasibility of selective NOM for penetrating splenic injury (PSI) is unclear. Unfortunately, little is known about the success rate of spleen-preserving surgical procedures. The aim of this study was to investigate the outcome of selective NOM for penetrating splenic injuries. METHODS: A dual-centre study is performed in two level-one trauma centres...
2017: World Journal of Emergency Surgery: WJES
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