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Thoracic trauma

M Weigeldt, M Paul, S Schulz-Drost, M D Schmittner
The management of anesthesia plays a central role in the treatment of thoracic trauma, both in the initial phase when safeguarding the difficult airway and in the intensive care unit. A rapid transfer to a trauma center should be considered in order to recognize and treat organ dysfunction in time. Development of atelectasis, pneumonia and acute lung failure are common pulmonary complications. Non-invasive ventilation combined with physiotherapy and respiratory training can help to minimize these pulmonary complications...
June 15, 2018: Der Unfallchirurg
Mark G Van Vledder, Vicky Kwakernaak, Tjebbe Hagenaars, Esther M M Van Lieshout, Michiel H J Verhofstad
BACKGROUND: High rates of pneumonia and death have been reported among elderly patients with rib fractures. This study aims to identify patterns of injury and risk factors for pneumonia and death in elderly patients with rib fractures. METHODS: A retrospective multicenter observational study was performed using data registered in the national trauma registry between 2008 and 2015 in the South West Netherlands Trauma region. Data regarding demographics, mechanism of injury, pulmonary and cardiovascular history, pattern of extra-thoracic and intrathoracic injuries, ICU admission, length of stay, and morbidity and mortality following admission were collected...
June 15, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Kaila A Holtz, Elena Szefer, Vanessa K Noonan, Brian K Kwon, Patricia B Mills
STUDY DESIGN: Prospective cohort study using the Rick Hansen SCI Registry (RHSCIR) and retrospective medical chart review. OBJECTIVE: To describe treatment patterns of in-patient anti-spasticity medication use following traumatic spinal cord injury (SCI) in acute and rehabilitation hospital settings in British Columbia, Canada. SETTING: Quaternary trauma center, rehabilitation center. METHODS: Individuals with traumatic SCI between 2005 and 2014 enrolled in the Vancouver RHSCIR site (N = 917) were eligible for inclusion...
June 14, 2018: Spinal Cord
Andrea M Walters, Mauria A O'Brien, Laura E Selmic, Sue Hartman, Maureen McMichael, Robert T O'Brien
OBJECTIVE: To determine the agreement between focused assessment with sonography for trauma (FAST) exams and computed tomography (CT) for the detection of pleural and peritoneal fluid and pneumothorax in animals that have sustained recent trauma. DESIGN: Prospective study. SETTING: University Teaching Hospital. ANIMALS: Thirteen dogs and 2 cats were enrolled into the study, with 10 having sustained blunt force trauma and 5 penetrating trauma...
June 14, 2018: Journal of Veterinary Emergency and Critical Care
Daniel McCarthy, Lenore Bacek, Kyoung Kim, George Miller, Philippe Gaillard, Kendon Kuo
OBJECTIVES:  To characterize the clinical features among dogs sustaining rib fractures and to determine if age, type and severity of injury, entry blood lactate, trauma score and rib fracture score were associated with outcome. METHODS:  A retrospective study was performed to include dogs that were presented with rib fractures. Risk factors evaluation included breed, age, body weight, diagnosis, presence of a flail chest, bandage use, puncture wound presence, rib fracture number, location of the fracture along the thoracic wall, hospital stay length, body weight, other fractures, pleural effusion, pulmonary contusions, pneumothorax and occurrence of an anaesthetic event...
June 11, 2018: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
Areg Grigorian, Dean Spencer, Carlos Donayre, Jeffry Nahmias, Sebastian Schubl, Viktor Gabriel, Cristobal Barrios
BACKGROUND: Blunt thoracic aortic injury (BTAI) occurs in <1% of all trauma admissions. Considering the advent of multiple thoracic endovascular aortic repair (TEVAR) devices over the past decade, improved outcomes of TEVAR supported in the literature, rapid diagnosis and improved preoperative planning of BTAI using computed tomography imaging, we hypothesized that the national incidence of TEVAR in BTAI has increased while open repair has decreased. In addition, we hypothesized that the mortality risk in BTAI patients undergoing TEVAR would be lower than open repair...
June 7, 2018: Annals of Vascular Surgery
Carolyn Moore, Golda Kwayisi, Prince Esiobu, Keren A Bashan-Gilzenrat, Leslie R Matthews, Jonathan Nguyen, Nathaniel Moriarty, Michael Liggon, Kahdi Udobi, Assad Taha, Ed Childs, Omar Danner
Hemothorax is a common occurrence after blunt or penetrating injury to the chest. Posterior intercostal vessel hemorrhage as a cause of major intrathoracic bleeding is an infrequent source of massive bleeding. Selective angiography with trans-catheter embolization may provide a minimally invasive and efficient method of controlling bleeding refractory to surgical treatment. PRESENTATION OF CASE: A 19 year-old male sustained a gunshot wound to his left chest with massive hemothorax and refractory hemorrhage...
May 3, 2018: International Journal of Surgery Case Reports
Chun Wu, Zhengxia Pan, Yuhao Wu, Quan Wang, Yonggang Li, Yong An, Hongbo Li, Gang Wang, Yi Wang, Jiangtao Dai
PURPOSE: To summarize the etiology and treatment of 119 patients with chylothorax in our hospital. METHODS: A total of 119 patients with chylothorax, divided into a neonate group, an infant group, and an older-than-1-year group, were included in our study and analyzed from January 2000 to July 2017 in the Children's Hospital of Chongqing Medical University. RESULTS: A total of 90 males and 29 females were included in our study. In the neonate group, 21 chylothorax cases were due to idiopathic factors, constituting 72...
May 18, 2018: Journal of Pediatric Surgery
Alexandra Pallottie, Ayomi Ratnayake, Li Ni, Cigdem Acioglu, Lun Li, Ersilia Mirabelli, Robert F Heary, Stella Elkabes
Spinal cord (SC) trauma elicits pathological changes at the primary lesion and in regions distant from the injury epicenter. Therapeutic agents that target mechanisms at the injury site are likely to exert additional effects in these remote regions. We previously reported that a toll-like receptor 9 (TLR9) antagonist, oligodeoxynucleotide 2088 (ODN 2088), improves functional deficits and modulates the milieu at the epicenter in mice sustaining a mid-thoracic contusion. The present investigations use the same paradigm to assess ODN 2088-elicited alterations in the lumbar dorsal horn (LDH), a region remote from the injury site where SCI-induced molecular alterations have been well defined...
June 7, 2018: Scientific Reports
Eliza E Moskowitz, Clay Cothren Burlew, Ann M Kulungowski, Denis D Bensard
BACKGROUND/PURPOSE: The utility of EDT in the adult trauma population, using well-defined guidelines, is well established, especially for penetrating injuries. Since the introduction of these guidelines, reports on the use of EDT for pediatric trauma have been published, and these series reveal a dismal, almost universally fatal, outcome for EDT following blunt trauma in the child. This report reviews the clinical outcomes of EDT in the pediatric population. MATERIALS/METHODS: We performed a review of EDT in the pediatric population using the published data from 1980 to 2017...
June 6, 2018: Pediatric Surgery International
Teresa Ojode, Joshua W Sappenfield
Thoracic trauma poses a risk of injury to the thoracic organs and great vessels, including the coronaries. We present an interesting case of occult, life-threatening coronary bypass graft injury resulting from thoracic trauma. In this case, the diagnosis and management were contingent on understanding the nature of the bypass graft, which was not apparent at the time of presentation in extremis . Ultimate hemostasis required cardiac catheterization and placement of an exclusionary stent. Though there are several case reports describing native coronary injury resulting from thoracic injury, we found a single case of thoracic trauma-associated coronary bypass graft injury, which was managed medically...
June 2018: Trauma Case Reports
Janosch Dahmen, Marko Brade, Christian Gerach, Martin Glombitza, Jan Schmitz, Simon Zeitter, Eva Steinhausen
BACKGROUND: The European Resuscitation Council guidelines for resuscitation in patients with traumatic cardiac arrest recommend the immediate treatment of all reversible causes, if necessary even prior to continuous chest compression. In the case of cardiac tamponade immediate emergency thoracotomy should also be considered. OBJECTIVE: The authors report the case of a 23-year-old male patient with multiple injuries including blunt thoracic trauma, which caused a witnessed cardiac arrest...
June 5, 2018: Der Unfallchirurg
Akihiko Hiyama, Hiroyuki Katoh, Daisuke Sakai, Masato Sato, Masahiro Tanaka, Masahiko Watanabe
BACKGROUND: Computed tomography (CT) analyses have reported that the prevalence of diffuse idiopathic skeletal hyperostosis (DISH) in Japan is 8.7-27.1%. However, these data were obtained using chest-abdominal CT, and no evaluations of sagittal, coronal, and axial images using whole-spine CT have been reported. The aim of this study was to investigate the prevalence and characteristic of DISH by whole spinal CT. METHODS: Participants were patients who had experienced trauma who had undergone whole-spine CT scanning based on the initial clinical practice guidelines for trauma in our institute from April 2015 to February 2018...
May 30, 2018: BMC Musculoskeletal Disorders
Raúl A Rosario-Concepción, Juan Carlos Pérez, Claudia Jiménez, Walter R Frontera, Carmen López-Acevedo
Introduction: Brown-Séquard Syndrome (BSS) is one of the rarest incomplete spinal cord syndromes. The combination of injuries to peripheral nerves and the central nervous system result in an array of symptoms that can result in overlapping clinical presentations and delayed diagnosis. Early detection of spinal cord injury in patients with peripheral nerve injury has been observed to have a positive effect on outcomes. Case presentation: This report discusses the case of a 29-year-old male patient with Brown-Sequard-Plus Syndrome (BSPS) and Brachial Plexopathy (BP) secondary to gunshot wound in the left inferior neck...
2018: Spinal Cord Series and Cases
Peng Wang, Feng Wang, Yan-Long Gao, Jia-Qi Li, Jing-Tao Zhang, De-Chao Miao, Yong Shen
Objective This study aimed to identify the risk factors for vertebral compression fractures in patients with osteoporosis. Methods A total of 864 patients with osteoporosis were enrolled in a retrospective study from February 2010 to June 2016. Patients with diseases, such as pathological fractures, high-energy direct injury to the thoracic or lumbar vertebrae, and severe spinal deformity, were excluded. The patients were divided into two groups: those with vertebral compression fractures (288) and those with no vertebral compression fractures (576)...
January 1, 2018: Journal of International Medical Research
Patrick C Bonasso, Melvin S Dassinger, Deidre L Wyrick, Lori A Gurien, Jeffrey M Burford, Samuel D Smith
PURPOSE: Pediatric surgeon performed bedside ultrasound (PSPBUS) is a targeted examination that is diagnostic or therapeutic. The aim of this paper is to review literature involving PSPBUS. METHODS: PSPBUS practices reviewed in this paper include central venous catheter placement, physiologic assessment (volume status and echocardiography), hypertrophic pyloric stenosis diagnosis, appendicitis diagnosis, the Focused Assessment with Sonography for Trauma (FAST), thoracic evaluation, and soft tissue infection evaluation...
May 8, 2018: Journal of Pediatric Surgery
Konstantin Mitev, Dashurie Neziri, Emil Stoicovski, Zan Mitrev
BACKGROUND: The healthcare system in developing countries is limited; particularly, medical specialties such as emergency and trauma medicine are underdeveloped. Consequently, trauma injuries sustained in traffic accidents result in chronic morbidity more often than similar cases in developed countries. Multiple rib fractures induce significant patient morbidity. Current international guidelines recommend a multidisciplinary, surgery-based treatment approach to achieve optimal clinical benefit...
May 29, 2018: Journal of Medical Case Reports
M Rehfeldt, A Slagman, B A Leidel, M Möckel, T Lindner
Background: Traumatic Pneumothorax (PTX) is a potentially life-threatening injury. It requires a fast and accurate diagnosis and treatment, but diagnostic tools are limited. A new point-of-care device (PneumoScan) based on micropower impulse radar (MIR) promises to diagnose a PTX within seconds. In this study, we compare standard diagnostics with PneumoScan during shock-trauma-room management. Patients and Methods: Patients with blunt or penetrating chest trauma were consecutively included in the study...
2018: Emergency Medicine International
Alice L Zhou, Luke W Bonham, Franco Verde
INTRODUCTION: CT is routinely performed to evaluate trauma patients. When a radiologist misses an acute finding, there could be serious adverse consequences. In many subspecialty settings, body radiologists and neuroradiologists both interpret the thoracic and lumbar spine. RADPEER has estimated general disagreement rates between radiologists to be 2.9%, but the disagreement rate between neuroradiologists and body radiologists in trauma settings remains unknown. METHODS: This retrospective case review examined reports from the past 10 years of adult CT scans of the chest, abdomen, and pelvis interpreted by body radiologists, with concurrent thoracic and lumbar spine reconstructions interpreted by neuroradiologists...
May 24, 2018: Journal of the American College of Radiology: JACR
Isabelle Francillard, Lou Grangeon, Aude Triquenot-Bagan, Ozlem Ozkul-Wermester
Cervical artery dissection is a frequent cause of stroke, more so in young patients. Innominate artery (IA) dissection is uncommon, and most often associated with dissection of other major arteries like the aorta. The leading cause of IA injury is high-energy thoracic trauma, as in motor vehicle crash. IA dissection after blunt trauma is rare. We described here the unusual case and iconography of an isolated IA dissection after rifle recoil initially presenting as a stroke.
May 26, 2018: Acta Neurologica Belgica
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