trauma thoracoabdominal

BACKGROUND: Facing the 0.7-22% incidence rate of hepatocellular carcinoma (HCC) with inferior vena cava tumor thrombus (IVCTT), there are usually no obvious symptoms and signs when the tumor thrombus completely blocks the IVCTT in the early stage.1.J Gastroenterol. 29:41-46;2.Hepatogastroenterology. 41:154-157;3.Clin Cardiol. 19:211-213; Once diagnosed, it is the end-stage manifestation without unified treatment for HCC with IVCTT, bringing poor prognosis. Without active treatment, the median survival time is only 3 months...

Acute pancreatitis is a sudden inflammation affecting the exocrine region of the pancreatic parenchyma. Infectious etiologies are rare. Here we report an exceptional case of a 44-year-old woman from a rural area who was referred to our hospital with fever and abdominal pain. A physical examination revealed pale skin and epigastric tenderness. Thoracoabdominal computed tomography revealed a Balthazar score of D. Serum laboratory findings revealed hemolytic anemia, hepatic cytolysis, and high C-reactive protein level...

BACKGROUND: Thoracic and abdominal computed tomography scans are widely used modalities for trauma patients in emergency department (ED). However, alternative diagnostic and follow-up tools are also needed, due to limitations such as high cost and exces-sive radiation exposure. This study aimed to investigate the utility of repeated extended focused abdominal sonography for trauma (rE-FAST) performed by the emergency physician in patients with stable blunt thoracoabdominal trauma. METHODS: This was a prospective, single-center diagnostic accuracy study...

BACKGROUND: Traumatic abdominal wall hernias (TAWH) are relatively uncommon; however, the shearing force that results in fascial disruption could indicate an increased risk of visceral injury. The aim of our study was to evaluate whether the presence of a TAWH was associated with intra-abdominal injury requiring emergent laparotomy. METHODS: The trauma registry was queried over an 8-year period (7/2012-7/2020) for adult patients with blunt thoracoabdominal trauma diagnosed with a TAWH...

Fulminant fat embolism syndrome (FES) occurring within 1 h after trauma is extremely rare. We report a case of fulminant FES that developed hyperacute nature after a traumatic injury. A 66-year-old woman was injured when she fell approximately 1.5 m down the stairs. She was rushed to our hospital. One minute after arrival, which was 49 min after the injury, her consciousness and respiratory status deteriorated. Thoracoabdominal and pelvic computed tomography revealed preexisting interstitial pneumonia, a left femoral neck fracture, and a left sacral fracture...

Traumatic rupture of the diaphragm is an uncommon injury, often diagnosed late as it is associated with concurrent abdominal and thoracic visceral injuries which are the main cause of morbidity and mortality. Diaphragmatic rupture has been reported in 1-7 % of the patients following major blunt thoracoabdominal trauma and 10-15 % of the patients following penetrating trauma. In an emergency scenario, open approach remains the mainstay of management; however the laparoscopic approach has been steadily gaining acceptance...

BACKGROUND: Comparisons across trauma systems are key to identifying opportunities to improve trauma care. We aimed to compare trauma service structures, processes and outcomes between the English National Health Service (NHS) and the province of Quebec, Canada. METHODS: We conducted a multicentre cohort study including admissions of patients aged older than 15 years with major trauma to major trauma centres (MTCs) from 2014/15 to 2016/17. We compared structures descriptively, and time to MTC and time in the emergency department (ED) using Wilcoxon tests...

Thoracoabdominal traumatism is a topical problem of modern medicine due to its wide prevalence, severe course and unfavorable outcome. This article presents an overview of the epidemiology, diagnosis, and surgical treatment of patients with thoracoabdominal injuries. It showed that the current incidence of thoracoabdominal injuries reaches 13.7-16.4% of all chest and abdominal injuries. Lethality in thoracoabdominal injuries ranges from 3.13% to 20%. In most cases these are patients of working age, with an average age of 27...

BACKGROUND: In this study, we present diagnostic and therapeutic approaches in diaphragmatic rupture cases secondary to trauma and treated using surgical intervention. METHODS: Between March 2010 and December 2020, a total of 24 patients (23 males, 1 female; mean age: 35.0±13.7 years; range, 18 to 61 years) who were operated for traumatic diaphragm rupture were retrospectively reviewed. Preoperative, intraoperative, and postoperative data of the patients were evaluated...

INTRODUCTION: Pediatric firearm injury became the leading cause of death among U.S. children in 2020. Studies evaluating wounding patterns in military and mass casualty shootings have provided insights into treatment and potential salvageability in adults, however, similar studies in the pediatric population do not exist. Hence, our study aimed to analyze wounding patterns of pediatric firearm fatalities and associated demographics and characteristics, such as place of death, to better understand pediatric firearm injuries, potential salvageability, and opportunities to reduce firearm deaths among vulnerable pediatric populations...

A 22-year-old male presented following a precordial stab. He was haemodynamically and metabolically normal. Initial investigations did not reveal pericardial fluid or haemothorax. At diagnostic laparoscopy, we encountered haemoperitoneum and a diaphragmatic injury through which the heart was visible. After pericardial washout, laparoscopic repair was effected. This case highlights a potential problem with extended focused assessment with sonography in trauma (eFAST) in that it will only be positive if there is an accumulation of pericardial fluid...

INTRODUCTION AND IMPORTANCE: Traumatic diaphragmatic injury (TDI), although rare, is associated with high mortality and morbidity and timely recognition is important. CASE PRESENTATION: We present a case of a 44-year-old male who fell from a three-story building and presented with complaints of shortness of breath and chest pain. On examination, his chest compression test and extended focused assessment with sonography in trauma (E-FAST) were positive. Chest X-ray showed loss of diaphragmatic contour, fracture of fifth to eleventh ribs on the left side, and opacities in the left hemithorax...

Background and Objectives: Abdominal trauma among severely injured patients with an injury severity score (ISS) of 16 and above can lead to potentially life-threatening injuries that might need immediate surgical intervention. Traumatic injuries to the diaphragm (TID) are a challenging condition often accompanied by other injuries in the thoracoabdominal region. Materials and Methods: We retrospectively analyzed the occurrence and clinical course of TID among severely injured patients treated at our center between 2008 and 2019 and compared them to other groups of severely injured patients without TID...

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Background: Diaphragmatic hernias with strangulated contents are a surgical challenge. Thoracoabdominal incisions are commonly used for a variety of thoracic and vascular cases, although rarely used for diaphragmatic hernias, which are typically repaired with laparotomy, thoracotomy, or minimally invasive approaches. Case report: We present the unique case of a 60-year-old, critically ill unstable patient with severe heart failure with a reduced ejection fraction (15-25%) and severe valve disease presenting with a left-sided diaphragmatic hernia containing strangulated small intestine and requiring urgent surgical exploration...

Hemostatic materials are very important for the treatment of a large number of bleeding trauma patients in battlefield and disaster environments. Different types of hemostatic materials need to be used for emergency hemostasis according to different injury parts and severity. At present, the first-aid hemostatic materials have been well applied to the bleeding of body surface wounds, limbs, and junctions, but there are still no ideal hemostatic materials in the early treatment of first aid for the deep and incompressible bleeding of thoracoabdominal cavity and visceral organs...

The De Ritis ratio is widely used to differentiate various causes of liver disease and serves as an independent prognostic predictor for different malignancies and non-malignant illnesses. This retrospective study aimed to identify the association between the De Ritis ratio on admission and mortality outcomes in adult thoracoabdominal trauma patients. A total of 2248 hospitalized adult trauma patients with thoracoabdominal injury, defined as an abbreviated injury scale (AIS) score ≥ 1 in the thoracic and abdominal regions, between 1 January 2009, and 31 December 2019, were included...

Splenosis is a rare condition described as the implantation of ectopic splenic tissue, usually after a splenic rupture. Thoracic splenosis refers to acquired ectopic splenic tissue found within the thoracic cavity, often caused by thoracoabdominal trauma or surgery. Most cases are asymptomatic and many years may elapse before they are incidentally discovered on chest radiography or thoracic computed tomography. Splenosis is often misinterpreted as a malignancy on initial imaging. We wish to highlight a rare case of thoracic splenosis presenting with calcified and non-calcified nodules...

INTRODUCTION: Liver injury is one of the most common abdominal traumas. The causes of military activity related injuries are gunshot wounds (up to 60-70%), while in peacetime-closed blunt abdominal trauma (up to 45-55%). The overall mortality is up to 40-60% and has higher rates in the group of wartime injury, among the male population over 65 years old and of low social status. PRESENTATION OF THE CASE: We report the management of a clinical case of a 34-year-old man with thoracoabdominal dumdum's bullet trauma in the case of which damage control tactics were applied in cooperation between two clinics in conditions of active hostilities...

BACKGROUND: The aim of this study, investigate the prognostic value of shock index (SI), which has been accepted for a long time, and glucose-potassium ratio (GPR), which has limited data in patients with trauma and those with isolated blunt thoracoabdominal trauma. METHODS: This retrospective observational study was conducted at the tertiary reference hospital. Consecutive patients aged 18 years and older treated for blunt thoracoabdominal trauma in the emergency department between August 2020 and February 2022 were included in the study...