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Splenic trauma

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https://www.readbyqxmd.com/read/28733741/tips-and-tricks-of-splenic-vessel-preservation-during-laparoscopic-distal-pancreatectomy
#1
Claire Goumard, Satoshi Ogiso, Masayuki Okuno, Jason B Fleming, Michael Kim, Ching-Wei D Tzeng, Jean-Nicolas Vauthey, Jeffrey E Lee, Claudius Conrad
BACKGROUND: While a laparoscopic approach can minimize postoperative morbidity in splenic vessel preserving (SVP) distal pancreatectomy (DP), this procedure can be technically challenging. A systematic approach to SVP minimizes the chances of vascular injury and maximizes the chances of successful splenic preservation. This video demonstrates a laparoscopic DP with SVP, highlighting technical tips and tricks that optimize the chances for SVP. PATIENT: The patient is a 14-year-old male with an incidentally discovered pancreatic tail mass...
July 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28723778/thoracic-splenosis-mimicking-a-pleuropneumonia-a-case-report
#2
Aurélie Baldolli, Solène Coeuret, Vincent Le Pennec, Denis Agostini, Renaud Verdon
RATIONALE: Splenosis is the development of one or more heterotopic splenic tissue autoimplants following rupture of the spleen and remains mostly asymptomatic. PATIENT CONCERNS: We report a case of a 50-year old post-traumatic splenectomized man admitted for a left side community acquired pneumonia resistant to antibiotics. DIAGNOSES: The diagnosis of intrathoracic ectopic spleen was suspected because of the history of spleen trauma with diaphragm rupture and the absence of Howell-Jolly bodies...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28700540/clinical-and-radiological-presentations-and-management-of-blunt-splenic-trauma-a-single-tertiary-hospital-experience
#3
Gaby Jabbour, Ammar Al-Hassani, Ayman El-Menyar, Husham Abdelrahman, Ruben Peralta, Mohammed Ellabib, Hisham Al-Jogol, Mohammed Asim, Hassan Al-Thani
BACKGROUND Splenic injury is the leading cause of major bleeding after blunt abdominal trauma. We examined the clinical and radiological presentations, management, and outcome of blunt splenic injuries (BSI) in our institution. MATERIAL AND METHODS A retrospective study of BSI patients between 2011 and 2014 was conducted. We analyzed and compared management and outcome of different splenic injury grades in trauma patients. RESULTS A total of 191 BSI patients were identified with a mean (SD) age of 26.9 years (13...
July 12, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28688660/impact-of-tranexamic-acid-on-coagulation-and-inflammation-in-murine-models-of-traumatic-brain-injury-and-hemorrhage
#4
Ryan M Boudreau, Mark Johnson, Rosalie Veile, Lou Ann Friend, Holly Goetzman, Timothy A Pritts, Charles C Caldwell, Amy T Makley, Michael D Goodman
BACKGROUND: Posttraumatic coagulopathy and inflammation can exacerbate secondary cerebral damage after traumatic brain injury (TBI). Tranexamic acid (TXA) has been shown clinically to reduce mortality in hemorrhaging and head-injured trauma patients and has the potential to mitigate secondary brain injury with its reported antifibrinolytic and antiinflammatory properties. We hypothesized that TXA would improve posttraumatic coagulation and inflammation in a murine model of TBI alone and in a combined injury model of TBI and hemorrhage (TBI/H)...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28686924/emergency-splenectomy-for-trauma-in-the-setting-of-splenomegaly-axillary-lymphadenopathy-and-incidental-b-cell-chronic-lymphocytic-leukemia-a-case-report
#5
Rodolfo J Oviedo, Andrew A Glickman
INTRODUCTION: The spleen is the most commonly injured intra-abdominal solid organ following blunt trauma. B-cell chronic lymphocytic leukemia (CLL) is the most common leukocytic dyscrasia affecting adults in Western countries. Splenomegaly with axillary and retroperitoneal lymphadenopathy are common physical findings. This case investigates an emergency splenectomy in a community hospital involving a 45-year-old man with blunt abdominal trauma following an assault with incidental splenomegaly and axillary lymphadenopathy, with surgical pathology findings of B-cell CLL...
June 23, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28670065/aortic-valve-perforation-secondary-to-blunt-force-trauma
#6
Sachin Mehta, Gibbs Wilson, Keith Suarez, Christopher D Chiles
Blunt chest trauma has seldom been reported as a cause of rupture of an aortic valve cusp. We report the case of a 63-year-old man who had a motor vehicle collision resulting in transection of the descending thoracic aorta, splenic pseudoaneurysm, and rupture of an aortic valve cusp causing severe aortic regurgitation. Despite replacement of the aortic valve, he died of multiorgan failure.
July 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28640113/spleen-implanting-in-the-fatty-liver-mimicking-hepatocarcinoma-in-a-patient-with-hepatitis-b-c-a-case-report-and-literature-review
#7
REVIEW
Meng-Yao Wang, Bao Li, Dan Chen, Ai-Lian Liu, Sahrish Qamar, Mei-Yu Sun
RATIONALE: Ectopic splenic autotransplantation refers to the heterotopic autotransplantation of splenic tissue and no treatment is necessary for it when patient is asymptomatic. Its incidence rate is reported up to 67% among patients with a history of splenic trauma and splenic surgery. The diagnosis of it before operation is really difficult, and it is easy to mimic as other tumors. PATIENT CONCERNS: We reported a 42-year-old man with hepatic splenosis, with history of splenectomy for traumatic splenic rupture 16 years ago and hepatitis B&C...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28637555/overview-of-nonoperative-blunt-splenic-injury-management-with-associated-splenic-artery-pseudoaneurysm
#8
Chet A Morrison, Brian W Gross, Matthew Kauffman, Katelyn J Rittenhouse, Frederick B Rogers
The delayed development of splenic artery pseudoaneurysm (SAP) can complicate the nonoperative management of splenic injuries. We sought to determine the utility of repeat imaging in diagnosing SAP in patients managed nonoperatively without angioembolization. We hypothesized that a significant rate of SAPs would be found in this population on repeat imaging. Patients undergoing nonoperative splenic injury management from January 2011 to June 2015 were queried from the trauma registry. Rates of repeat imaging, angioembolization, readmission, and SAP development were analyzed...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28616605/splenic-laceration-after-routine-colonoscopy-a-case-report-of-a-rare-iatrogenic-complication
#9
Shuo Li, Nishant Gupta, Yogesh Kumar, Frank Mele
Colonoscopy is a common and routine procedure performed in the United States, most commonly performed for screening of colorectal cancer. Although colonoscopy is considered a safe procedure, it is associated with complications including intestinal hemorrhage and perforation. Splenic trauma, such as laceration or even complete rupture is a rarely reported, but potentially fatal complication if undetected. We present a case of splenic laceration with subcapsular hematoma status post routine colonoscopy. Fortunately, patient was able to be managed medically, without further operative intervention...
2017: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28604373/blunt-hepatic-and-splenic-trauma-a-single-center-experience-using-a-multidisciplinary-protocol
#10
Paolo Ruscelli, Farncesco Buccoliero, Susanna Mazzocato, Giulio Belfiori, Claudio Rabuini, Pierluigi Sperti, Massimiliano Rimini
AIM: The aim of this retrospective study was to describe more than 10 years experience of a single Trauma Center about non operative management of abdominal organ injuries in hemodynamically stable patients MATERIAL OF STUDY: Between January 2001 and December 2014 ,732 consecutive patients were admitted with blunt abdominal trauma, involving liver and/or spleen and/or kidney, at the Bufalini Cesena Hospital .Management of patients included a specific institutional developed protocol :hemodynamic stability was evaluated in shock room according to the patients response to fluid challenge and the patients were classified into three categories A,B,and C...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28600670/management-of-blunt-splenic-injury-in-a-uk-major-trauma-centre-and-predicting-the-failure-of-non-operative-management-a-retrospective-cross-sectional-study
#11
Stella R Smith, Louise Morris, Stephen Spreadborough, Waleed Al-Obaydi, Marta D'Auria, Hilary White, Adam J Brooks
PURPOSE: To review the management of patients >16 years with blunt splenic injury in a single, UK, major trauma centre and identify whether the following are associated with success or failure of non-operative management with selective use of arterial embolization (NOM ± AE): age, Injury Severity Score (ISS), head injury, haemodynamic instability, massive transfusion, radiological hard signs [contrast extravasation or pseudoaneurysm on the initial computed tomography (CT) scan], grade, and presence of intraparenchymal haematoma or splenic laceration...
June 9, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28584502/laparoscopic-splenectomy-in-hemodynamically-stable-blunt-trauma
#12
Gregory S Huang, Elisha A Chance, Barbara M Hileman, Eric S Emerick, Emily A Gianetti
BACKGROUND AND OBJECTIVES: No criteria define indications for laparoscopic splenectomy in trauma. This investigation compared characteristics of trauma patients and outcomes between laparoscopic and open splenectomies. METHODS: Patients were identified retrospectively by using ICD-9 codes. Included patients were 18 or older, with a blunt splenic injury from January 1, 2011, through December 31, 2014, and required splenectomy. Excluded patients had penetrating trauma, successful nonoperative management, or successful embolization...
April 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28570347/natural-history-of-splenic-vascular-abnormalities-after-blunt-injury-a-western-trauma-association-multicenter-trial
#13
Ben L Zarzaur, Julie A Dunn, Brian Leininger, Margaret Lauerman, K Shanmuganathan, Krista Kaups, Kirellos Zamary, Jennifer L Hartwell, Ankur Bhakta, John Myers, Stephanie Gordy, Samuel R Todd, Jeffrey A Claridge, Erik Teicher, Jason Sperry, Alicia Privette, Ahmed Allawi, Clay Cothren Burlew, Adrian A Maung, Kimberly A Davis, Thomas Cogbill, Stephanie Bonne, David H Livingston, Raul Coimbra, Rosemary A Kozar
BACKGROUND: Following blunt splenic injury (BSI) there is conflicting evidence regarding the natural history and appropriate management of patients with vascular injuries of the spleen such as pseudoaneurysms or blushes. The purpose of this study was to describe the current management and outcomes of patients with PSA or BLUSH. METHODS: Data was collected on adult (≥18) patients with BSI and a splenic vascular injury from 17 trauma centers. Demographic, physiologic, radiographic, and injury characteristics were gathered...
May 30, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28565815/epidemiology-and-management-of-splenic-injury-an-analysis-of-a-chinese-military-registry
#14
Yong Chen, Jun Qiu, Ao Yang, Danfeng Yuan, Jihong Zhou
In China, there have been few meta-analyses of the epidemiology and management of splenic injury. Due to the success of Chinese military hospitals in the domestic treatment of splenic injury, the present study conducted a systematic review of such cases, identifying a high occurrence rate of splenic trauma, as well as a number of strategies of managing splenic injury in China. Data were collected from sixteen Chinese military hospitals between July 2000 and March 2009, and retrospectively reviewed. It was observed that between July 2000 and March 2009 a total of 7,807 patients (84...
May 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28551865/pearls-and-pitfalls-of-hepatobiliary-and-splenic-trauma-what-every-trauma-radiologist-needs-to-know
#15
REVIEW
Joseph A Graves, Tarek N Hanna, Keith D Herr
With the universal acceptance of contrast-enhanced computed tomography (CT) as the imaging modality of first resort in the assessment of blunt abdominal injury, the trauma radiologist must be able to accurately and rapidly identify the range of CT manifestations of the traumatized abdomen. In this article, we lay out the fundamental principles in CT interpretation of blunt trauma to the hepatobiliary system and spleen, including vascular injury, with a focus on technical and interpretive pearls and pitfalls...
May 27, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28543860/a-unique-case-of-bilateral-ovarian-splenosis-and-review-of-the-literature
#16
Maria Giulia Disanto, Francesca Mercalli, Andrea Palicelli, Alberto Arnulfo, Renzo Boldorini
Splenosis is an acquired anomaly related to heterotopic auto-transplantation of splenic tissue following abdominal trauma or splenectomy. We report the first definitive bilateral ovarian case in a 65-year-old woman who underwent splenectomy following a motor vehicle accident 44 years prior to presentation. We review the literature and discuss the main differential diagnoses. Gross examination revealed a 1-cm well-circumscribed dark nodule on the surface of each ovary. Paraffin-embedded, formalin-fixed blocks were sectioned and stained with hematoxylin-eosin and immunostains (CK5/6, Calretinin, WT1, Vimentin)...
May 25, 2017: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
https://www.readbyqxmd.com/read/28501136/delayed-splenic-vascular-injury-after-nonoperative-management-of-blunt-splenic-trauma
#17
Alessandro Furlan, Mitchell E Tublin, Mitchell A Rees, Dederia H Nicholas, Jason L Sperry, Louis H Alarcon
BACKGROUND: Delayed splenic vascular injury (DSVI) is traditionally considered a rare, often clinically occult, harbinger of splenic rupture in patients with splenic trauma that are managed conservatively. The purpose of our study was to assess the incidence of DSVI and associated features in patients admitted with blunt splenic trauma and managed nonoperatively. MATERIALS AND METHODS: A retrospective analysis was conducted over a 4-y time. Patients admitted with blunt splenic trauma, managed no-operatively and with a follow-up contrast-enhanced computed tomography (CT) scan study during admission were included...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28498097/the-asplenic-patient-post-insult-immunocompetence-infection-and-vaccination
#18
Brandon Dionne, Walter Dehority, Meghan Brett, Thomas R Howdieshell
BACKGROUND: Splenic injury can occur through multiple mechanisms and may result in various degrees of residual immunocompetence. Functionally or anatomically asplenic patients are at higher risk for infection, particularly with encapsulated bacteria. Vaccination is recommended to prevent infection with these organisms; however, the recommendations are routinely updated, and vaccine selection and timing are complex. METHODS: Review of the pertinent English-language literature, including the recommendations of the U...
July 2017: Surgical Infections
https://www.readbyqxmd.com/read/28492407/the-spleen-not-taken-differences-in-management-and-outcomes-of-blunt-splenic-injuries-in-teenagers-cared-for-by-adult-and-pediatric-trauma-teams-in-a-single-institution
#19
Sean O'Connor, Andrea N Doud, Leah M Sieren, Preston R Miller, Kristen A Zeller
BACKGROUND: Non-operative management (NOM) of blunt splenic injury, initially touted for the care of pediatric patients, has become the standard of care for stable trauma patients of all ages. In our institution, trauma patients <16 years old are managed by the pediatric surgery service and patients ≥16 years are managed by the adult trauma service. Angioembolization is routinely employed for adults with blunt splenic injury but rarely used for pediatric patients. A retrospective chart review was performed to determine if more liberal use of angioembolization increases the success rate of NOM of blunt splenic injury in adolescents...
May 11, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28464541/accuracy-of-dual-bolus-single-acquisition-computed-tomography-in-the-diagnosis-and-grading-of-adult-traumatic-splenic-parenchymal-and-vascular-injury
#20
Paul Marovic, Paul Anthony Beech, Jim Koukounaras, Helen Kavnoudias, Gerard S Goh
INTRODUCTION: Dual Bolus Single Acquisition Computed Tomography (DBSA-CT) has been advocated for use in trauma imaging through its ability to concurrently optimise abdominal arterial and visceral parenchymal enhancement while minimising scan times and radiation dose. However, concerns have been raised regarding excessive splenic parenchymal heterogeneity using this technique. The purpose of this study is to establish and compare the accuracy of DBSA-CT to traditional sequential multiphase scanning techniques in the diagnosis and grading of traumatic adult splenic injury...
May 2, 2017: Journal of Medical Imaging and Radiation Oncology
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