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Splenic trauma

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https://www.readbyqxmd.com/read/28228201/five-year-retrospective-review-of-blunt-renal-injuries-at-a-level-i-trauma-center
#1
Jessica Burns, Megan Brown, Zakaria I Assi, Eric J Ferguson
We report the experience of a Level I trauma center in the management of blunt renal injury during a 5-year period, with special attention to those treated using angiography with embolization. The institutional trauma registry was queried for all patients with blunt renal injury between September 1, 2009 and August 30, 2014. Each injury was graded using the American Association for the Surgery of Trauma guidelines. Patients that underwent angiography with embolization were reviewed for case-specific information including imaging findings, treatment, materials used, clinical course, and mortality...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28210364/caudal-edge-of-the-liver-in-the-right-upper-quadrant-ruq-view-is-the-most-sensitive-area-for-free-fluid-on-the-fast-exam
#2
Viveta Lobo, Michelle Hunter-Behrend, Erin Cullnan, Rebecca Higbee, Caleb Phillips, Sarah Williams, Philips Perera, Laleh Gharahbaghian
INTRODUCTION: The focused assessment with sonography in trauma (FAST) exam is a critical diagnostic test for intraperitoneal free fluid (FF). Current teaching is that fluid accumulates first in Morison's pouch. The goal of this study was to evaluate the "sub-quadrants" of traditional FAST views to determine the most sensitive areas for FF accumulation. METHODS: We analyzed a retrospective cohort of all adult trauma patients who had a recorded FAST exam by emergency physicians at a Level I trauma center from January 2012 - June 2013...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28184357/delayed-splenic-rupture-normal-appearing-spleen-on-the-initial-multidetector-computed-tomography-mdct-can-sometimes-be-misleading
#3
Alireza Hamidian Jahromi, Matias Migliaro, Melisa Romano, Guillermo Sangster
INTRODUCTION: Delayed splenic rupture (DSR) is an unusual outcome following blunt abdominal trauma. Although DSR is defined as bleeding more than 48 hours after blunt trauma in a previously hemodynamically stable patient, a review of the reported cases in the literature shows that in almost all of the cases the initial CT imaging revealed some form of damage to the spleen. CASE PRESENTATION: Here we describe an extremely rare condition in a case that presented with a DSR following blunt trauma and had a normal appearing spleen in the initial post trauma MDCT scan...
November 2016: Trauma Monthly
https://www.readbyqxmd.com/read/28139109/-distal-pancreatectomy-with-splenic-preservation-in-pediatric-patient-with-blunt-abdominal-trauma
#4
J T Palacios-Zertuche, J G Martínez-Flores, Q Gilte-Limas, M A Pinzón-Uresti, F J Reyna-Sepúlveda, G E Muñoz-Maldonado
INTRODUCTION: Traumatic injuries of the pancreas occur in 3 to 12% of cases of blunt abdominal trauma in children and these are associated with a mortality of 30%. CASE REPORT: A four-year-old girl was brought to the emergency room after an automobile accident. On physical examination, she was stable with abdominal pain and signs of peritoneal irritation. An abdominal CT scan showed a grade II liver lesion, a grade II splenic lesion, and a grade III pancreatic lesion...
April 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28130582/does-coronal-oblique-length-of-spleen-on-ct-reflect-splenic-index
#5
Venkatraman Indiran, Naorem Vinod Singh, T Ramachandra Prasad, Prabakaran Maduraimuthu
AIMS AND OBJECTIVES: Splenic dimension of >12 cm on coronal plane on ultrasound is considered to represent splenomegaly. We sought to estimate the accuracy of similar coronal oblique length of spleen on CT in identifying splenomegaly by comparing it with CT splenic index. We also sought to establish the splenic width, craniocaudal dimension (CC), thickness, and coronal oblique length in both normal and splenomegaly groups. MATERIALS AND METHODS: 319 consecutive patients undergoing CT abdomen were included in the study and measurements of width (W), CC, thickness (T), and coronal oblique length (L) made...
January 27, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28119438/atraumatic-splenic-rupture-secondary-to-epstein-barr-virus-infection
#6
Jessica Barnwell, Paramjeet Singh Deol
We present a case report of atraumatic splenic rupture secondary to Epstein-Barr virus (EBV) infection. A woman aged 36 years presented to a London teaching hospital's Accident and Emergency department with severe abdominal pain following a 6-day history of diarrhoea and vomiting, which had been under review by her GP. A CT scan demonstrated free intraperitoneal fluid and abnormal appearance of her spleen. Blood tests demonstrated EBV infection with positive serology and leucocytosis. She underwent a laparoscopic washout, which confirmed a subcapsular splenic haematoma that was initially managed conservatively...
January 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28099390/to-nearly-come-full-circle-nonoperative-management-of-high-grade-iv-v-blunt-splenic-trauma-is-safe-utilizing-a-protocol-with-routine-angioembolization
#7
Indermeet S Bhullar, Joseph J Tepas, Daniel Siragusa, Todd Loper, Andrew Kerwin, Eric R Frykberg
INTRODUCTION: Nonoperative management (NOM) of hemodynamically stable high grade (IV-V) blunt splenic trauma (BST) remains controversial given the high failure rates (19%) that persist despite angioembolization (AE) protocols. The NOM protocol was modified in 2011 to include mandatory AE of all grade (IV-V) injuries without CB along with selective AE of grade (I-V) with CB. The purpose of this study was to determine if this new AE protocol significantly lowered the failure rates for grade (IV-V) injuries allowing for safe observation without surgery and if the exclusion of grade III injuries allowed for the prevention of unnecessary angiograms without affecting the overall failure rates...
January 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28050441/blunt-cardiac-rupture-a-diagnostic-challenge
#8
Suraj Pinni, Vineet Kumar, Satish Balkrishna Dharap
Blunt Cardiac Rupture (BCR) is a life threatening injury. Majority of patients do not reach the hospital and in those who reach the emergency department, timely diagnosis and treatment is a challenge. The case is about a patient with multiple blunt injuries who presented in shock. Cardiac tamponade was suspected on clinical grounds and on evidence of mediastinal widening on radiograph. In the absence of songography, the diagnosis was confirmed by subxiphoid pericardial window. Emergency thoracotomy revealed a right atrial appendage rupture which was surgically corrected...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28034773/randomized-clinical-trial-of-ligasure%C3%A2-versus-conventional-splenectomy-for-injured-spleen-in-blunt-abdominal-trauma
#9
Vejdan Seyyed Amirkazem, Khosravi Malihe
BACKGROUND: Spleen is the most common organ damaged in cases of blunt abdominal trauma and splenectomy and splenorrhaphy are the main surgical procedures that are used in surgical treatment of such cases. In routine open splenectomy cases, after laparotomy, application of sutures in splenic vasculature is the most widely used procedure to cease the bleeding. This clinical trial evaluates the role and benefits of the Ligasure™ system in traumatic splenectomy without using any suture materials and compares the result with conventional method of splenectomy...
February 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28027808/-splenic-rupture-secondary-to-abscess-rare-cause-of-pneumoperitoneum-case-report
#10
Jorge Enrique Barrón-Reyes, Julio César Chávez-Galván, Jesús Alejandro Martínez-Peralta, Julio César López-Valdés
BACKGROUND: Splenic abscesses are rare entities; reports are commonly described in immunocompromised patients (72%) as: hematologic diseases, diabetes, endocarditis, acquired immunodeficiency syndrome, transplant patients and subjects who had abdominal trauma or splenic infarction. The main and most serious complication is the abscess rupture into the peritoneal cavity or adjacent organs (stomach or colon), which determines hemodynamic instability or septic state. CLINICAL CASE: Fifty-year-old man, who was admitted at Emergency Room due eight days' progressive, oppressive, and current pain; intensity 4/10, irradiated at hemi-back, which was higher intensity during the standing and decreased at supine position...
December 24, 2016: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/28007589/rectovaginal-splenosis-an-unexpected-cause-of-dyspareunia-approached-by-laparoscopy
#11
Hélder Ferreira, Cristina Maciel, Alexandre Morgado, António Pereira
STUDY OBJECTIVE: To demonstrate the technique of laparoscopic approach in a rare case of rectovaginal splenosis with severe dyspareunia and dyschesia. DESIGN: A step-by-step explanation of the patient's condition, diagnosis, surgical technique, and postoperative results (Canadian Task Force classification II-3). SETTING: Splenosis consists of ectopic functioning splenic tissue that can be located anywhere within the abdomen or pelvis. Fragments are often multiple and range in diameter from a few millimeters to a few centimeters...
December 19, 2016: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/27923205/spontaneous-rupture-of-splenic-hematoma-in-a-malaria-patient-case-report-and-review-of-literature
#12
Bassem M Abou Hussein, Ali M Al Ani, Omar Al-Mayoofi, Mahpara Mehraj, Afra A Joher, Juanita A Bonilla, Alya S Al-Mazrouei, Faisal M Badri
INTRODUCTION: Blunt abdominal trauma is the most common cause of splenic rupture. Malaria is the most frequent tropical infectious cause of spontaneous splenic rupture. The exact mechanism is not well-defined. CASE REPORT: We report a case of thirty-year-old male patient known to have malaria who presented with spontaneous splenic rupture. A trial of conservative treatment failed and splenecomy was done to control bleeding. CONCLUSION: Spontaneous splenic rupture should be kept in mind in malaria patients presenting with left upper quadrant pain and signs of hypovolemia...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27913838/isolated-transverse-process-fractures-insignificant-injury-or-marker-of-complex-injury-pattern
#13
G Lombardo, P Petrone, K Prabhakaran, C P Marini
INTRODUCTION: This study investigates the incidence of isolated transverse process fractures (ITPFx) amongst vertebral fractures in trauma patients, and specific-associated injury patterns present in patients with ITPFx. MATERIALS AND METHODS: A retrospective, 4-year review of our Level 1 Trauma Center registry was performed. Patients with blunt spinal column fractures were identified. Data collected included patient demographics, Injury Severity Score (ISS), type of imaging obtained, and concomitant injuries, including rib and pelvic fractures, liver, spleen, and kidney injury (SOI)...
December 2, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27911067/-vascular-interventional-radiology-a-fundamental-procedure-for-the-management-of-paediatric-trauma
#14
E Bordón Cabrera, A Laín, R Gander, M Pérez Lafuente, I Díez Miranda, C G Fontecha, L Seidler, I Delgado, S Cañadas Palazón, J Lloret
INTRODUCTION: The management of active bleeding with haemodinamic lability in the paediatric trauma patient is difficult and generally leads to damage control surgery. Vascular Interventional Radiology (VIR) techniques are useful for the diagnosis as for the definitive treatment. AIM: The aim of our study was to describe our experience and evaluate effectiveness of VIR in the management of the paediatric trauma patient with active bleeding signs. METHODS: Retrospective analysis (2003-2014) of politraumatic patients who showed contrast blush on computed tomography and then treated by VIR techniques...
January 25, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/27904307/hybrid-transvaginal-notes-and-mini-laparoscopic-colectomy-benefit-through-synergy
#15
Jayson M Moloney, Philip S L Gan
BACKGROUND AND OBJECTIVES: Hybrid-natural orifice surgery combines the advantages of traditional transabdominal laparoscopic surgery, while limiting surgical trauma to the abdominal wall. Among various routes of intra-abdominal access, the transvaginal method is most appealing because of its utility and proven safety. We describe a series of 4 colonic resections performed with this approach, combined with minilaparoscopy and needlescopic approaches, and discuss the technical aspects, efficacy, and applicability of this technique...
October 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/27893644/western-trauma-association-critical-decisions-in-trauma-management-of-adult-blunt-splenic-trauma-2016-updates
#16
Susan E Rowell, Walter L Biffl, Martin A Schreiber, Roxie A Albrecht, Mitchell J Cohen, Marc DeMoya, Riyad Karmy-Jones, Ernest E Moore, Nicholas Namias, David V Shatz, Frederick A Moore, Karen Brasel
No abstract text is available yet for this article.
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27866649/management-of-paediatric-splenic-injury-in-the-new-south-wales-trauma-system
#17
Susan E Adams, Andrew Holland, Julie Brown
: Since the 1980's, paediatric surgeons have increasingly managed blunt splenic injury (BSI) in children non-operatively. However, studies in North America have shown higher operation rates in non-paediatric centres and by adult surgeons. This association has not been examined elsewhere. OBJECTIVE: To investigate the management of BSI in New South Wales (NSW) children, to determine the patient and hospital factors related to the odds of operation. Secondarily, to investigate whether the likelihood of operation varied by year...
January 2017: Injury
https://www.readbyqxmd.com/read/27849328/early-post-traumatic-splenic-arteriovenous-fistula-in-the-pancreatic-arcade-diagnosis-by-volume-rendered-3d-reconstruction-images
#18
Junya Tsurukiri, Hidefumi Sano, Hoshiai Akira, Naoyuki Kaneko
Arteriovenous fistula (AVF) of splenic vessels is rare. It is most commonly caused by spontaneous rupture of an extant splenic artery aneurysm into an adjacent vein, or by traumatic or iatrogenic pseudoaneurysm. Blunt abdominal trauma can sometimes lead to vascular damage to spleen, resulting in AVF formation. Presently described is case of an elderly patient with high-grade splenic injury. Early post-traumatic AVF was detected by volume-rendered 3D reconstruction using fused arterial and venous phase computed tomography (CT) images...
September 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/27843669/a-case-of-a-chronic-pancreatic-pseudocyst-causing-atraumatic-splenic-rupture-without-evidence-of-acute-pancreatitis
#19
P Moori, E J Nevins, T Wright, C Bromley, Y Rado
Atraumatic splenic rupture is a rare complication of a pancreatic pseudocyst (PP), described in the setting of chronic pancreatitis. There is common understanding, within the literature, that an inflammatory process at the tail of the pancreas may disrupt the spleen and result in such splenic complications. The authors present a case report of a 29-year-old male with a PP, associated with chronic pancreatitis. The patient had a history of excessive alcohol intake and presented to the emergency department with a short history of abdominal pain and vomiting...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27818226/primary-care-of-the-blunt-splenic-injured-adult
#20
REVIEW
Brian K Yorkgitis
The spleen is the most commonly injured abdominal organ in blunt trauma. Immediate treatment is aimed at assessing for bleeding and abating it when it is severe. Methods for the management of blunt splenic injury-associated bleeding include observation, splenectomy, and splenic salvage procedures through splenorrhaphy or embolization. After blunt splenic injury, complications commonly occur, including bleeding, infection, thrombosis, and pneumonia. If a patient undergoes splenectomy, infections can be severe...
March 2017: American Journal of Medicine
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