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https://www.readbyqxmd.com/read/28930046/canadian-benchmarks-for-acute-injury-care
#1
Lynne Moore, David Evans, Natalie L Yanchar, Jaimini Thakore, Henry Thomas Stelfox, Sayed Morad Hameed, Richard Simons, John Kortbeek, Julien Clément, François Lauzier, Alexis F Turgeon
BACKGROUND: Acute care injury outcomes vary substantially across Canadian provinces and trauma centres. Our aim was to develop Canadian benchmarks to monitor mortality and hospital length of stay (LOS) for injury admissions. METHODS: Benchmarks were derived using data from the Canadian National Trauma Registry on patients with major trauma admitted to any level I or II trauma centre in Canada and from the following patient subgroups: isolated traumatic brain injury (TBI), isolated thoracoabdominal injury, multisystem blunt injury, age 65 years or older...
October 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28898729/evaluation-of-the-multi-slice-computed-tomography-outcomes-in-diaphragmatic-injuries-related-to-penetrating-and-blunt-trauma
#2
REVIEW
Mehmet Turmak, Muhammed Akif Deniz, Cihan Akgül Özmen, Aydın Aslan
PURPOSE: Traumatic diaphragmatic rupture is a diagnostic challenge for both surgeons and radiologists and generally occurs secondary to blunt and penetrating trauma of thoracoabdominal region. MATERIAL AND METHODS: 56 patients who underwent surgical procedure due to blunt or penetrating trauma were included to the study. RESULTS: There were 37 diaphragmatic ruptures in the left side and 19 patients in the right side. The most common radiological finding was "the direct monitoring of defect" (54,3%)...
September 6, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28881905/perforated-esophageal-intervention-focus-perf-study-a-multi-center-examination-of-contemporary-treatment
#3
J T Ali, R D Rice, E A David, J D Spicer, J J Dubose, L Bonavina, S Siboni, T A O'Callaghan, X Luo-Owen, S Harrison, C G Ball, J Bini, G A Vercruysse, D Skarupa, C C Miller Iii, A L Estrera, K G Khalil
The treatment of esophageal perforation (EP) remains a significant clinical challenge. While a number of investigators have previously documented efficient approaches, these were mostly single-center experiences reported prior to the introduction of newer technologies: specifically endoluminal stents. This study was designed to document contemporary practice in the diagnosis and management of EP at multiple institutions around the world and includes early clinical outcomes. A five-year (2009-2013) multicenter retrospective review of management and outcomes for patients with thoracic or abdominal esophageal perforation was conducted...
November 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28876672/civilian-gunshot-wounds-to-the-chest-a-clinicopathological-analysis-of-an-annual-caseload-at-a-level-1-trauma-centre
#4
V M Meijering, A T Hattam, P H Navsaria, A J Nicol, S Edu
BACKGROUND: Gunshot wounds (GSW) to the chest are common presentations to trauma centres in South Africa. The clinical management and outcome of GSW to the chest are significantly altered by missile trajectory and the associated anatomical structures injured making them challenging injuries to treat. Currently, the management of GSW chest is based on scant evidence and treatment is typically according to algorithms based largely on the anecdotal experience of high volume institutions and experienced clinicians...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876667/evaluation-of-thoracoscopy-in-the-diagnosis-of-diaphragmatic-injuries-in-penetrating-thoracoabdominal-trauma-without-lung-deflation-at-dr-george-mukhari-academic-hospital
#5
L Nsakala
BACKGROUND: With a mortality estimated at 25% when missed, diaphragmatic injuries due to penetrating thoracoabdominal trauma present a diagnostic challenge for both the radiologist and the surgeon. In the current literature, chest x-ray has a sensitivity of 27-60% for left-sided injuries and only 17% for right-sided injuries while, CT scan has a sensitivity of 14-61% and a specificity of 76-99%. Thoracoscopy using a single lung ventilation is one of the modalities of choice for the diagnosis of these injuries with a specificity of 100% and a sensitivity of 87...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876661/the-use-of-laparoscopy-in-managing-penetrating-thoracoabdominal-injuries-in-africa-83-cases-reviewed
#6
M Z Koto, F Mosai, O Y Matsevych
BACKGROUND: The use of laparoscopy in managing haemodynamically stable patients with penetrating thoracoabdominal injuries in developed countries is wildly practised, but in Africa the use of laparoscopy is still in its infancy stage. METHOD: A retrospective analysis of prospectively collected data of patients presenting with penetrating thoracoabdominal injuries was done. All patients offered laparoscopic exploration and repair from January 2012 to December 2015 at Dr George Mukhari Academic Hospital were analysed...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28838022/-characteristics-and-treatment-strategies-for-penetrating-injuries-on-the-example-of-gunshot-and-blast-victims-without-ballistic-body-armour-in-afghanistan-2009%C3%A2-%C3%A2-2013
#7
Christoph Güsgen, Arnulf Willms, Ines Richardsen, Dan Bieler, Erwin Kollig, Robert Schwab
Much like other countries, Germany has recently seen terrorist attacks being planned, executed or prevented at the last minute. This highlights the need for expertise in the treatment of penetrating torso traumas by bullets or explosions. Data on the treatment of firearm injuries and, even more so, blast injuries often stems from crises or war regions. However, it is difficult to compare injuries from such regions with injuries from civilian terrorist attacks due to the ballistic body protection (protective vests, body armour) worn by soldiers...
August 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28790100/missed-diaphragmatic-injury-after-blunt-trauma-presenting-with-colonic-strangulation-a-rare-scenario
#8
Atish Kumar, Dinesh Bagaria, Amulya Ratan, Amit Gupta
Diaphragmatic rupture occurs in 4%-5% cases of thoracoabdominal injuries. It may present acutely, in a delayed fashion or as a complicated hernia. We are describing the case of a young male presenting in respiratory distress with history of chest trauma 1.5 years back. On investigation, he was found to have left side diaphragmatic hernia containing gangrenous colon with lung collapse. The patient underwent successful operative intervention and discharged after 25 days of hospital stay. Record review suggested that the above mentioned diaphragm injury was missed in his evaluation 1...
August 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28690745/closed-reduction-of-a-traumatic-hip-dislocation-in-children-case-report
#9
Achraf El Bakkaly, Fouad Ettayebi, Houda Oubeja, Mounir Erraji, Hicham Zerhouni
Traumatic dislocation of the hip in children is a rare disease. It only represents 5% of hip dislocations in all age groups. Before 10 years, the mechanism is often a minimal domestic accident; after 10 years, the dislocation occurs with the waning of an accident of the public highway. It is different from that of the adult by its rarity, its ease of reduction and better prognosis. This is an emergency trauma: risk necrosis of the femoral head (If delayed reduction). We report a rare case of a 3 year old boy, who suffered from bipolar trauma after a fall near his height of his house causing him a detachment of the right humerus and post-traumatic dislocation of the left hip...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28681368/a-case-of-incarcerated-and-perforated-stomach-in-delayed-traumatic-diaphragmatic-hernia
#10
Shinjiro Wakai, Hiroyuki Otsuka, Hiromichi Aoki, Takeshi Yamagiwa, Yoshihide Nakagawa, Sadaki Inokuchi
The patient was an emergency transported, 57-year-old man complaining of left thoraco-lateroabdominal pain, with a history of blunt chest trauma 3 months prior. Thoracoabdominal computed tomography (CT) resulted in a diagnosis of diaphragmatic hernia with incarceration and perforation of the stomach, and same-day emergency surgery was performed. The surgery was performed via an abdominal approach, and after manually repositioning the stomach incarceration, the perforated region was resected and the diaphragm sutured closed...
July 20, 2017: Tokai Journal of Experimental and Clinical Medicine
https://www.readbyqxmd.com/read/28659919/the-%C3%AE-d-endoglucuronidase-heparanase-is-a-danger-molecule-that-drives-systemic-inflammation-and-correlates-with-clinical-course-after-open-and-endovascular-thoracoabdominal-aortic-aneurysm-repair-lessons-learnt-from-mice-and-men
#11
Lukas Martin, Alexander Gombert, Jianmin Chen, Julia Liebens, Julia Verleger, Johannes Kalder, Gernot Marx, Michael Jacobs, Christoph Thiemermann, Tobias Schuerholz
Thoracoabdominal aortic aneurysm (TAAA) is a highly lethal disorder requiring open or endovascular TAAA repair, both of which are rare, but extensive and complex surgical procedures associated with a significant systemic inflammatory response and high post-operative morbidity and mortality. Heparanase is a β-d-endoglucuronidase that remodels the endothelial glycocalyx by degrading heparan sulfate in many diseases/conditions associated with systemic inflammation including sepsis, trauma, and major surgery. We hypothesized that (a) perioperative serum levels of heparanase and heparan sulfate are associated with the clinical course after open or endovascular TAAA repair and (b) induce a systemic inflammatory response and renal injury/dysfunction in mice...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28630645/the-use-of-laparoscopy-in-managing-penetrating-thoracoabdominal-injuries-in-africa-83-cases-reviewed
#12
Zach M Koto, Fusi Mosai, Oleh Y Matsevych
BACKGROUND: The use of laparoscopy in managing haemodynamically stable patients with penetrating thoracoabdominal injuries in developed countries is wildly practiced, but in Africa, the use of laparoscopy is still in its infancy stage. We reviewed a single centre experience in using laparoscopy in Africa for management of patients with both isolated diaphragmatic injuries as well as diaphragmatic injuries associated with intra-abdominal injuries requiring intervention. METHODS: A retrospective analysis of prospectively collected data of patients presenting with penetrating thoracoabdominal injuries was done...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28594796/hybrid-surgery-in-chronic-thoracoabdominal-aortic-dissection
#13
A M Cherniavskiĭ, D A Sirota, T Caus, D S Khvan, S A Al'sov, M M Liashenko
The authors describe and analyse their experience gained in performing prosthetic repair of the thoracoabdominal portion of the aorta, combined with open aortic stenting using the Djumbodis uncovered metal stent. Over the period from 2013 to 2015 we performed a total of 16 hybrid interventions. All patients were found to have type B aortic dissection, with their false and true lumens patent. All patients underwent reconstruction of the thoracoabdominal aorta combined with open implantation of the Djumbodis uncovered metal stent into the area of lower thoracic and visceral arteries...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28561632/-traumatic-asphyxia-with-permanent-visual-loss-case-report
#14
Tibor Kántor, Bianca Grigorescu, Gabriel Popescu, Attila Ferencz, Örs Nagy, János Jung, István Gergely
Traumatic asphyxia is a rare condition that occurs after compressive thoracoabdominal trauma, which is characterized by subconjunctival hemorrhage, cervicofacial cyanosis, edema and petechiae. Serious life-threatening thoracic and abdominal injuries may coexist. After conservatory treatment in most cases complete recovery is achieved, but in isolated cases permanent neurological lesions may occur. We present the case of the 39-year-old male patient who suffered a compressive thoracoabdominal trauma. The physical examination showed the characteristic "ecchymotic mask"...
June 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28400216/high-mortality-rates-after-both-open-surgical-and-endovascular-thoracic-aortic-interventions-in-patients-with-end-stage-renal-disease
#15
COMPARATIVE STUDY
Nathan L Liang, Theodore H Yuo, Georges E Al-Khoury, Eric S Hager, Michel S Makaroun, Michael J Singh
BACKGROUND: Morbidity and mortality have improved with the evolution of endovascular techniques (thoracic endovascular aortic repair [TEVAR]) for thoracic aortic disease, but results after aortic intervention in patients with end-stage renal disease (ESRD) remain unclear. The objective of this study was to evaluate outcomes of open and endovascular descending thoracic aortic repair in dialysis-dependent patients. METHODS: We identified 352 patients with ESRD on dialysis undergoing open repair (n = 136) or TEVAR (n = 216) of the thoracic aorta from 2005 to 2008 using the United States Renal Data System database...
October 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28372447/gallbladder-perforation-after-closed-thoracoabdominal-trauma-diagnosed-and-treated-by-ercp
#16
David Ruiz-Clavijo, María Rullan, Marian Casi, Jesús María Urman
Single gallbladder injury after abdominal trauma is a rare finding. Early diagnosis of this disease is often difficult due to the variability of symptoms and unspecific results in the usual radiological tests. The usual management in patients with vesical trauma is surgery. We report a case of a patient with a gallbladder perforation after closed thoracoabdominal trauma diagnosed and treated with ERCP and a conservative management with good clinical evolution.
April 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28112018/reversed-frozen-elephant-trunk-technique-to-treat-a-type-ii-thoracoabdominal-aortic-aneurysm
#17
E Sebastian Debus, Tilo Kölbel, Sabine Wipper, Holger Diener, Beate Reiter, Christian Detter, Nikolaos Tsilimparis
PURPOSE: To describe a hybrid technique of reversed frozen elephant trunk to treat thoracoabdominal aortic aneurysms (TAAA) through an abdominal only approach. TECHNIQUE: The technique is demonstrated in a 29-year-old Marfan patient with a chronic type B aortic dissection previously treated with a thoracic stent-graft who presented with a thoracoabdominal false lumen aneurysm. Through an open distal retroperitoneal approach to the abdominal aorta, a frozen elephant trunk graft was implanted over a super-stiff wire upside down with the stent-graft component in the thoracic aorta...
April 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28028649/application-of-a-modified-thoracoabdominal-approach-that-avoids-cutting-open-the-costal-portion-of-diaphragm-during-anterior-thoracolumbar-spine-surgery
#18
Jiandang Shi, Xuefeng Yue, Ningkui Niu, Chen Zhao, Hongyan Qiu, Zili Wang
PURPOSE: In the present prospective randomized controlled study, we compared the feasibility and effectiveness of our modified thoracoabdominal approach to anterior thoracolumbar spine surgery without cutting open the costal portion of diaphragm (extradiaphragmatic approach) with the traditional transdiaphragmatic thoracoabdominal approach. The traditional combined thoracoabdominal approach in anterior thoracolumbar surgery for spine tuberculosis is effective but seriously damages the diaphragm and causes various lung complications...
July 2017: European Spine Journal
https://www.readbyqxmd.com/read/28009748/mortality-in-canadian-trauma-systems-a-multicenter-cohort-study
#19
MULTICENTER STUDY
Lynne Moore, David Evans, Sayed M Hameed, Natalie L Yanchar, Henry T Stelfox, Richard Simons, John Kortbeek, Gilles Bourgeois, Julien Clément, François Lauzier, Avery Nathens, Alexis F Turgeon
OBJECTIVE: To measure the variation in trauma center mortality across Canadian trauma systems, assess the contribution of traumatic brain injury and thoracoabdominal injury to observed variations, and evaluate whether the presence of recommended trauma system components is associated with mortality. SUMMARY BACKGROUND DATA: Injuries represent one of the leading causes of mortality, disability, and health care costs worldwide. Trauma systems have improved injury outcomes, but the impact of trauma system configuration on mortality is unknown...
January 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28004325/remarkable-ct-features-of-shock-thyroid-in-traumatic-and-non-traumatic-patients
#20
Dae Hee Han, Eun Ju Ha, Joo Sung Sun, So Lyung Jung
Shock thyroid is a part of the hypovolemic shock complex, which is a constellation of secondary computed tomographic (CT) findings that are observed in patients with hypovolemic shock. However, to the best of our knowledge, there has only been a single report on this condition, which described three cases associated with significant thoracoabdominal trauma. Here, we report four patients with profound hypotension who exhibited similar CT findings as those described in the initial report on shock thyroid, but with a more diverse clinical spectrum...
June 2017: Emergency Radiology
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