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Splenic trauma

Zuodong Song, Ting Ye, Longfei Ma, Longlong Shao, Dong Lin, Shujun Jiang, Jiaqing Xiang
Studies have shown that splenic artery ligation without splenectomy can successfully control hemorrhage and preserve the spleen in splenic trauma. The short gastric arteries and left gastroepiploic arteries may be the most important part of the collateral blood supply to the spleen. Moreover, that the human spleen can also survive even if most of the short gastric arteries have been ligated along with the splenic artery has also been proven. Revascularization of the spleen by collateral vessels from the superior mesenteric, pancreatic, and left inferior phrenic arteries has been demonstrated by celiac angiography...
November 2016: Annals of Thoracic Surgery
Ai-Ling Chen, Xi Sun, Wei Wang, Jin-Feng Liu, Xin Zeng, Jing-Fan Qiu, Xin-Jian Liu, Yong Wang
BACKGROUND: Immunosuppression has been described as a consequence of brain injury and infection by different mechanisms. Angiostrongylus cantonensis can cause injury to the central nervous system and eosinophilic meningitis to human. Both T cell and B cell immunity play an essential role in the resistance of the infection. However, whether brain injury caused by A. cantonensis infection can lead to immunosuppression is not clear. Therefore, the present study sought to observe the alteration of immune responses in mice infected with A...
October 12, 2016: Journal of Neuroinflammation
Nathan Vaughan, Jeff Tweed, Cynthia Greenwell, David M Notrica, Crystal S Langlais, Shawn D St Peter, Charles M Leys, Daniel J Ostlie, R Todd Maxson, Todd Ponsky, David W Tuggle, James W Eubanks, Amina Bhatia, Cynthia Greenwell, Nilda M Garcia, Karla A Lawson, Prasenjeet Motghare, Robert W Letton, Adam C Alder
INTRODUCTION: Obesity is an epidemic in the pediatric population. Childhood obesity in trauma has been associated with increased incidence of long-bone fractures, longer ICU stays, and decreased closed head injuries. We investigated for differences in the likelihood of failure of non-operative management (NOM), and injury grade using a subset of a multi-institutional, prospective database of pediatric patients with solid organ injury (SOI). METHODS: We prospectively collected data on all pediatric patients (<18years) admitted for liver or splenic injury from September 2013 to January 2016...
September 13, 2016: Journal of Pediatric Surgery
Jason Reinglas, Kirstin Perdrizet, Stephen E Ryan, Rakesh V Patel
Splenosis, the autotransplantation of splenic tissue following splenic trauma, is uncommonly clinically significant. Splenosis is typically diagnosed incidentally on imaging or at laparotomy and has been mistakenly attributed to various malignancies and pathological conditions. On the rare occasion when splenosis plays a causative role in a pathological condition, a diagnostic challenge may ensue that can lead to a delay in both diagnosis and treatment. The following case report describes a patient presenting with a massive upper gastrointestinal bleed resulting from arterial enlargement within the gastric fundus secondary to perigastric splenosis...
2016: Clinical and Experimental Gastroenterology
Jack W Rostas, Timothy B Lively, Sidney B Brevard, Jon D Simmons, Mohammad A Frotan, Richard P Gonzalez
BACKGROUND: The purpose of this study was to identify patients with rib injuries who were at risk for solid organ injury. METHODS: A retrospective chart review was performed of all blunt trauma patients with rib fractures during the period from July 2007 to July 2012. Data were analyzed for association of rib fractures and solid organ injury. RESULTS: In all, 1,103 rib fracture patients were identified; 142 patients had liver injuries with 109 (77%) associated right rib fractures...
August 28, 2016: American Journal of Surgery
F Van der Cruyssen, A Manzelli
BACKGROUND: The spleen is the second most commonly injured organ in cases of abdominal trauma. Management of splenic injury depends on the clinical status of the patient and can include nonoperative management (NOM), splenic artery embolization (SAE), surgery (operative splenic salvage or splenectomy), or a combination of these treatments. In nonoperatively managed cases, SAE is sometimes used to control haemorrhage. However, the indications for SAE have not been clearly defined and, in some cases, the potential complications of the procedure may outweigh its benefits...
2016: World Journal of Emergency Surgery: WJES
Ting-Min Hsieh, Tzu-Hsien Tsai, Yueh-Wei Liu, Ching-Hua Hsieh
BACKGROUND: Although angioembolization increases the success rate of non-operative management in patients with blunt splenic injuries (BSI), the issue of contrast-induced nephropathy (CIN) due to serial administration of contrast medium remains unclear. We aimed to examine the risk factors of CIN and their clinical effect on mortality in patients with BSI. METHOD: We retrospectively studied the complete data on 377 trauma patients with BSI who survived more than 48 h between July 2003 and June 2015...
September 10, 2016: International Journal of Surgery
Vasileios Rafailidis, Annamaria Deganello, Tom Watson, Paul S Sidhu, Maria E Sellars
Contrast-enhanced Ultrasound (CEUS) represents a complementary technique to grey-scale and colour Doppler ultrasonography (US) which allows for real-time visualization and characterization of tissue perfusion. Its inherent advantages in the child makes US an ideal imaging modality; repeatability and good tolerance along with the avoidance of computed tomography (CT), a source of ionizing radiation, renders US imaging desirable. Although currently paediatric CEUS is principally used in an "off-label" manner, US contrast agents have received regulatory approval for assessment of paediatric focal liver lesions in the United States of America...
September 9, 2016: British Journal of Radiology
Walter Bugiantella, Federico Crusco, Nicola Avenia, Rondelli Fabio
UNLABELLED: Splenosis is the autoimplantation of splenic tissue to ectopic sites after spleen injury. Although splenosis most commonly occurs in the abdomen, it may occur in the thorax in case of diaphragm rupture. Thoracic splenosis (TS) is often asymptomatic and is diagnosed incidentally in the course of chest examination. We describe the case of a man, with a history of thoracoabdominal trauma, undergoing routine chest radiography with the evidence of radio-opaque images close to the inferior left curvature of the cardiac shadow, which resulted to be nodules of TS at the contrast enhanced CT scan...
2016: Annali Italiani di Chirurgia
L Brouwers, M Bemelman, W L M Kramer, F H W M van der Heijden
- In 90% of children, blunt abdominal trauma is the cause of renal, splenic or hepatic injury or an injury affecting a combination of these organs.- Because children's kidneys are anatomically less protected than those of adults, potential renal injury following direct trauma affecting the child's flank, for example by a handlebar or knee should be considered.- Symptoms of renal trauma include excoriations or haematoma on the flank, a 'seatbelt-sign', macroscopic haematuria and fractures of the ribs and vertebra...
2016: Nederlands Tijdschrift Voor Geneeskunde
Amarvir Bilkhu, Frances Mosley, Jay A Gokhale
New anticoagulants such as Rivaroxaban have become a popular choice for patients needing anticoagulation for atrial fibrillation or venous thromboembolism, chiefly because anticoagulation is maintained without the need for monitoring. This can be problematic in cases of trauma, and in this article, we discuss the management and outcome of managing an elderly patient with a shattered spleen while on Rivaroxaban.
2016: Journal of Surgical Case Reports
Lacy E Lowry, Jonathan A Goldner
BACKGROUND: Spontaneous splenic rupture associated with anticoagulant use is a rare but potentially lethal disorder. Lack of prompt recognition can be associated with poor patient outcomes. The use of novel oral anticoagulants is becoming more common and thus consideration of this disorder while evaluating a patient who presents with abdominal pain while using these agents is extremely important. This is the first reported case of spontaneous splenic rupture associated with apixaban. CASE PRESENTATION: We describe the clinical case of an 83-year-old white man who complained of sudden severe abdominal pain 5 days into a hospital stay for acute-on-chronic congestive heart failure and exacerbation of chronic obstructive pulmonary disease...
2016: Journal of Medical Case Reports
Özüm Tunçyürek, Pars Tunçyürek, Ersen Ertekin, Mustafa Gök, Emir Hüseyin Nevai, Füruzan Kaçar Döger, Yelda Özsunar
INTRODUCTION: Atraumatic spontaneous rupture of the spleen is an uncommon but fatal condition that may coexist with other disease. Our case was presented with obvious CT findings of a spontaneous rupture of the spleen. PRESENTATION OF THE CASE: A 75-year-old woman admitted to the emergency service with abdominal pain. Although there was no evident splenomegaly in the abdominal CT examination, the patient was diagnosed with diffuse large B-cell lymphoma, and densities in harmony with the free air were detected in the spleen and the abdomen...
2016: International Journal of Surgery Case Reports
Mary Arbuthnot, Chinwendu Onwubiko, David Mooney
BACKGROUND: In the case of the hemodynamically unstable child, splenorrhaphy is preferred to splenectomy to avert postsplenectomy sepsis. However, successful splenorrhaphy requires familiarity with the procedure. We sought to determine how many splenectomies or splenorrhaphies for trauma the average pediatric surgeon can be expected to perform during their career. METHODS: The Pediatric Health Information System (PHIS) Database was queried for patients ≤18years coded with an International Classification of Diseases 9th Edition diagnosis code of a splenic injury from 2004 to 2013...
November 2016: Journal of Pediatric Surgery
Paul D Rodrigue, Asif A Fakhri, Jin T Lim
After a significant trauma to the spleen, small viable splenic fragments may exist in the peritoneal cavity, however less commonly they may be located in the thorax. Thus, the appearance of splenules within the thorax on CT imaging can be easily mistaken for malignancy and lead to unnecessary intervention. Here, we present a case of multiple pulmonary masses initially presumed to be malignancy leading to CT guided biopsy that were eventually imaged using 99mTc-labeled sulfur colloid scinitigraphy and confirmed to be thoracic splenules...
August 4, 2016: Journal of Nuclear Medicine Technology
R Pande, A Saratzis, J Winter Beatty, C Doran, R Kirby, C Harmston
INTRODUCTION Blunt abdominal trauma (BAT) is a common injury in recent trauma series. The characteristics of patients with BAT have changed following the reconfiguration of UK trauma services. The aim of this study was to build a new profile for BAT patients undergoing immediate or delayed laparotomy. METHODS All 5,401 consecutive adults presenting with major trauma between April 2012 and April 2014 in the 3 major trauma centres in the West Midlands were analysed to identify all patients with BAT. A total of 2,793 patients with a mechanism of injury or symptomatology consistent with BAT were identified (52%)...
August 4, 2016: Annals of the Royal College of Surgeons of England
Nikolaj Hjort Schmidt, Poul Edling
Acute splenic rupture can be a life-threatening condition which needs immediate attention. We report a case where parenchymal splenic lesions and subcapsular haematoma were developed after a patient was being hit with a water balloon from a slingshot. The patient was treated conservatively but developed an arteriovenous fistula which was treated with central arterial coiling. We discuss the need for acute computed tomography after relevant trauma as well as the evidence for follow-up scans and management of splenic pseudoaneurysms with splenic arterial embolization...
July 25, 2016: Ugeskrift for Laeger
Ting-Min Hsieh, Tsung-Cheng Tsai, Yueh-Wei Liu, Ching-Hua Hsieh
BACKGROUND: High-grade blunt hepatic and/or splenic injuries (BHSI) remain a great challenge for trauma surgeons. The main aim of this study was to investigate the characteristics, mortality rates, and outcomes of high-grade BHSI in motorcyclists and car occupants hospitalized for treatment of traumatic injuries in a Level I trauma center in southern Taiwan. METHODS: High-grade BHSI are defined as grade III-VI blunt hepatic injuries and grade III-V blunt splenic injuries...
2016: International Journal of Environmental Research and Public Health
Tze L Chia, Tyler R Chesney, David Isa, Gevork Mnatzakanian, Errol Colak, Caio Belmont, Dhruvin Hirpara, Precilla V Veigas, Sergio A Acuna, Sandro Rizoli, Joao Rezende-Neto
INTRODUCTION: Thrombocytosis is common following elective splenectomy and major trauma. However, little is known about the in-hospital course of platelet count (PC) and incidence of thrombocytosis after splenic trauma. Extreme thrombocytosis (PC>1000×10(9)) is associated with increased risk of venous thromboembolism (VTE) in primary thrombocytosis leading to the use of acetylsalicylic acid (ASA) for risk reduction, but the need for this agent in splenic trauma is undefined. METHODS: Retrospective cohort study of all patients with splenic trauma between April 1, 2010 and March 31, 2014...
July 16, 2016: Injury
Ahmet Can Topcu, Ufuk Ciloglu, Ahmet Bolukcu, Sabri Dagsali
Traumatic aortic rupture is rupture of all or part of the aortic wall, mostly resulting from blunt trauma to the chest. The most common site of rupture is the aortic isthmus. Traumatic rupture of the ascending aorta is rare. A 62-year-old man with a family history of ascending aortic aneurysm was referred to our hospital after a motor vehicle accident. He had symptoms of cardiogenic shock. A contrast-enhanced computed tomographic scan revealed rupture of the proximal ascending aorta and an ascending aortic aneurysm with a diameter of 55 mm at the level of the sinuses of Valsalva...
August 2016: Annals of Thoracic Surgery
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