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Thoracic trauma

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https://www.readbyqxmd.com/read/28340013/implications-of-thoracic-epidural-analgesia-on-hospital-charges-in-rib-fracture-patients
#1
Courtney D Jensen, Jamie T Stark, Lewis E Jacobson, Jan M Powers, Kathy L Leslie, Jeffrey M Kinsella-Shaw, Michael F Joseph, Craig R Denegar
Objective.:  Rib fractures are present in more than 150,000 patients admitted to US trauma centers each year. Those who fracture two or more ribs are typically treated with oral analgesic drugs and are discharged with few complications. The cost of this care generally reflects its brevity. When a patient fractures three or more ribs, there is an elevated risk of complication. In response, treatments are often broadened and their durations prolonged; this affects cost. While health, function, and survival have been widely explored, patient billing has not...
March 7, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28329116/spontaneous-haemothorax-caused-by-a-ruptured-oesophageal-artery
#2
Wenxiong Zhang, Yongbing Wu, Xiaoqiang Zhang, Han Jiang
Spontaneous haemothorax is a subcategory of haemothorax that occurs in the absence of trauma or other causes. It is a rare emergency that can progress rapidly with massive blood loss leading to haemorrhagic shock and death. We describe a patient with massive spontaneous haemothorax caused by the disruption of an oesophageal artery from the middle segment of descending thoracic aorta. We sutured the bleeding artery in an emergency thoracotomy after the failure of interventional procedure.
February 22, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28327950/a-new-classification-for-pathologies-of-spinal-meninges-part-2-primary-and-secondary-intradural-arachnoid-cysts
#3
Jörg Klekamp
BACKGROUND: Spinal intradural arachnoid cysts are rare causes of radiculopathy or myelopathy. Treatment options include resection, fenestration, or cyst drainage. OBJECTIVE: To classify intradural spinal arachnoid cysts and present results of their treatment. METHODS: Among 1519 patients with spinal space occupying lesions, 130 patients demonstrated intradural arachnoid cysts. Neuroradiological and surgical features were reviewed and clinical data analyzed...
March 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28320201/analysis-of-never-events-following-adult-cardiac-surgical-procedures-in-the-united-states
#4
Michael P Robich, Brianna M Krafcik, Nishant K Shah, Alik Farber, Denis Rybin, Jeffrey J Siracuse
BACKGROUND: This study was conducted to determine the risk factors, nature, and outcomes of "never events" following open adult cardiac surgical procedures. Understanding of these events can reduce their occurrence, and thereby improve patient care, quality metrics, and cost reduction. METHODS: "Never events" for patients included in the Nationwide Inpatient Sample who underwent coronary artery bypass graft, heart valve repair/replacement, or thoracic aneurysm repair between 2003-2011 were documented...
March 16, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28318811/st-elevation-myocardial-infarction-after-penetrating-thoracic-trauma
#5
Kiran Faryar, Michael P Flaherty, Martin Huecker
BACKGROUND: ST-segment elevation myocardial infarction (STEMI) may complicate penetrating thoracic trauma. CASE REPORT: This report describes a 42-year-old man who sustained a self-inflicted gunshot wound to the left chest. Electrocardiogram showed ST elevation in the inferior leads. Emergent catheterization was not recommended and conservative management was initiated. Cardiac catheterization 4 days later showed no perturbation of the coronary arteries, neither atherosclerotic nor traumatic...
March 17, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28317616/review-of-166-gunshot-injury-cases-in-dogs
#6
Hrvoje Capak, Nika Brkljaca Bottegaro, Ana Manojlovic, Ozren Smolec, Drazen Vnuk
The study is aimed to establish predilection signalment and history data, and to investigate clinical findings and risk factors associated with a poor outcome in dogs with projectile injuries. A retrospective study was undertaken of 166 canine cases in which a projectile was found on radiograph in a university׳s diagnostic imaging center more than a 4-year period. The study included dogs with both apparent (obvious recent traumatic event) and incidental (traumatic event unknown to the owner) projectile injury...
December 2016: Topics in Companion Animal Medicine
https://www.readbyqxmd.com/read/28303066/cervical-chyloma-after-neck-dissection-a-case-report
#7
Masashi Kimura, Hiroyuki Ohto, Akio Shibata, Hiroki Yamada, Shusuke Nishiwaki, Masahiro Umemura
Cervical chylomas are rare pseudocystic collections that lack an epithelial lining and arise from the thoracic duct or its tributaries; although they typically develop after neck surgery or trauma, they can arise from unknown causes. Treatment options include not only conservative therapy, such as dietary modification, repeated aspirations, and sclerotherapy, but also include surgical excision. We describe a case of a chyloma in a 64-year-old Japanese woman with squamous cell carcinoma of the gingiva. The chyloma developed following left segmental mandibulectomy with radical neck dissection and reconstruction, using a titanium plate and a pectoralis major myocutaneous flap...
February 2017: Nagoya Journal of Medical Science
https://www.readbyqxmd.com/read/28302283/pediatric-thoracic-trauma-current-trends
#8
Erik G Pearson, Caitlin A Fitzgerald, Matthew T Santore
Pediatric thoracic trauma is relatively uncommon but results in disproportionately high levels of morbidity and mortality when compared with other traumatic injuries. These injuries are often more devastating due to differences in children׳s anatomy and physiology relative to adult patients. A high index of suspicion is of utmost importance at the time of presentation because many significant thoracic injuries will have no external signs of injury. With proper recognition and management of these injuries, there is an associated improved long-term outcome...
February 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28301867/an-intercostal-muscular-hernia-as-a-consequence-of-intercostal-nerve-root-compromise-after-trauma-to-the-thoracic-spine
#9
Myron M LaBan
'True' intercostal hernias, that is, those containing both pleura and lung components, occur infrequently. Only 300 cases have been reported since Rolland's initial description in 1499. Rarer still are intercostal muscle hernias, which occur without containing pulmonary components. In both instances, males predominate, usually a consequence of direct blunt chest trauma. In many instances, recognition of the intercostal muscle hernia may be delayed from weeks to months, its diagnosis masked by more obvious evidence of physical trauma...
April 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28299808/pneumopericardium-as-a-rare-complication-after-esophagopericardial-fistula
#10
Hai-Qin Liao, Dan Zhou, Quan-Liang Shang, Yi-Fan Shi, Ming Zhang
Pneumopericardium is a rare clinical entity which is often complicated by trauma. Pneumoperdicardium resulting after esophagopericardial fistula is much rarer. We present a case of pneumopericardium as the complication of esophagopericardial fistula in a 53-year-old man. After undergoing radiotherapy for 26 times, the patient got a fever and an unspecified thoracic pain. Echocardiography showed the rectilinear echoes in the pericardium. Chest computed tomography revealed pneumopericardium, pericardial effusion, recurrence of lung cancer, and pneumonia in right lower and left lung...
March 16, 2017: Echocardiography
https://www.readbyqxmd.com/read/28294662/-endovascular-treatment-of-blunt-thoracic-aortic-injuries
#11
Zsuzsanna Mihály, Péter Banga, Lilla Szatai, Árpád Simonffy, Daniele Mariastefano Fontanini, Judit Bélteki, Bianka Forgó, Zoltán Szeberin
INTRODUCTION: A new era has begun in the last two decades with the advent of endovascular methods in the therapy of blunt thoracic aorta injuries. Our experiences with the endovascular interventions of blunt aortic trauma in the Cardiovascular Center of Semmelweis University are summarised here. METHODS: We included those patients who underwent endovascular intervention due to blunt aortic trauma in a university hospital between 1998 and 2014. The statistical analysis was performed with the use of Excel...
March 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28291768/case-report-of-serratus-plane-catheter-for-pain-management-in-a-patient-with-multiple-rib-fractures-and-an-inferior-scapular-fracture
#12
Peter Fu, Paul D Weyker, Christopher A J Webb
We placed a superficial serratus anterior plane catheter in an elderly woman with dementia and elevated clotting times who presented with multiple rib fractures after a mechanical fall. She was not a surgical candidate, and treatment consisted of conservative management with physical therapy and pain control. She was not a candidate for a patient-controlled analgesia regimen because of her dementia. Given her elevated international normalized ratio, thoracic epidural and paravertebral analgesia was also contraindicated...
March 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28286845/pan-vs-selective-computed-tomography-scans-in-management-of-multiple-trauma-patients-a-brief-report
#13
Anita Sabzghabaei, Majid Shojaee, Hamid Kariman, Mohammad Manouchehrifar, Kamran Heydari, Sirus Sohrabi
INTRODUCTION: Using pan or selective computed tomography (CT) scan in management of multiple trauma patient is a matter of debate. Therefore, the present study was designed aiming to compare the findings of pan and selective CT scans in management of multiple trauma patients. METHOD: This is a prospective cross-sectional study, on patients presented to the emergency department (ED) of Shohadaye Haftome Tir Hospital, Tehran, Iran, following blunt multiple trauma over a 1-year period, from March 2014 to March 2015...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28286834/thoracic-injury-rule-out-criteria-in-prediction-of-traumatic-intra-thoracic-injuries-a-validation-study
#14
Setareh Asgarzadeh, Bahareh Feizi, Farhad Sarabandi, Morteza Asgarzadeh
INTRODUCTION: Doing Chest X Ray (CXR) for all trauma patients is not efficient and cost effective due to its low diagnostic value. The present study was designed aiming to evaluate the diagnostic accuracy of thoracic injury rule out criteria (TIRC) in prediction of traumatic intra-thoracic injuries and need for CXR. METHOD: The present study is a prospective cross-sectional study that has been carried out to evaluate the accuracy of TIRC model in screening blunt multiple trauma patients in need of CXR for ruling out intra-thoracic injuries...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28286275/spontaneous-pyogenic-spondylodiscitis-in-the-thoracic-or-lumbar-spine-a-retrospective-cohort-study-comparing-the-safety-and-efficacy-of-minimally-invasive-and-open-surgery-over-a-nine-year-period
#15
Lennart Viezens, Christian Schaefer, Rachel Helmers, Eik Vettorazzi, Malte Schroeder, Nils Hansen-Algenstaedt
PURPOSE: Pyogenic spondylodiscitis is a rare disease, but its incidence is increasing. Over the last decade, spinal surgery has been modified to become minimally invasive. In degenerative spinal disorders, such minimally invasive surgery (MIS) reduces blood loss, muscular trauma and the hospital stay. However, it is not known whether MIS also confers these benefits to patients with pyogenic spondylodiscitis. This retrospective cohort study compared the safety and efficacy of minimally invasive surgery (MIS) and the conventional open surgical procedure in patients with pyogenic spondylodiscitis...
March 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28277467/high-energy-pediatric-scapula-fractures-and-their-associated-injuries
#16
Steven F Shannon, Nicholas M Hernandez, Stephen A Sems, Annalise N Larson, Todd A Milbrandt
OBJECTIVES: The purpose of this study was to evaluate pediatric scapula fractures occurring in high-energy motorized vehicle accidents and their associated injury patterns in a pediatric patient population. METHODS: One thousand nine hundred sixty-eight pediatric patients who presented after either on-road or off-road motorized vehicle accidents between 1996 and 2015 were retrospectively reviewed. Thirty-eight patients were found to have scapula fractures and the remaining 1930 were identified as controls...
March 8, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28275495/resection-of-pulmonary-nodule-in-a-patient-with-subglottic-stenosis-under-modified-spontaneous-ventilation-anesthesia
#17
Jianfei Shen, Xuewei Chen, Lixia Liang, Kevin Phan, Jin-Shing Chen, Calvin S H Ng, Rene Horsleben Petersen, Diego González-Rivas, Jianxing He
Subglottic stenosis is an uncommon structural abnormality that can pose as a difficulty for patients undergoing surgery, and treatment is complex due to the special anatomical location. Pulmonary nodule resection in patients with subglottic stenosis is challenging and has not yet been reported. Here we present a case of pulmonary nodule resection in a patient with subglottic stenosis using uniportal thoracoscopy under spontaneous ventilation anesthesia (SVA). Compared with traditional double lumen endotracheal intubation, we believe this modified technique can significantly reduce airway trauma, and accelerate patient recovery...
February 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28264437/transplantation-of-embryonic-spinal-cord-derived-cells-helps-to-prevent-muscle-atrophy-after-peripheral-nerve-injury
#18
Carolin Ruven, Wen Li, Heng Li, Wai-Man Wong, Wutian Wu
Injuries to peripheral nerves are frequent in serious traumas and spinal cord injuries. In addition to surgical approaches, other interventions, such as cell transplantation, should be considered to keep the muscles in good condition until the axons regenerate. In this study, E14.5 rat embryonic spinal cord fetal cells and cultured neural progenitor cells from different spinal cord segments were injected into transected musculocutaneous nerve of 200-300 g female Sprague Dawley (SD) rats, and atrophy in biceps brachii was assessed...
February 27, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28259576/female-sex-independently-predicts-mortality-after-thoracic-endovascular-aortic-repair-for-intact-descending-thoracic-aortic-aneurysms
#19
Sarah E Deery, Katie E Shean, Grace J Wang, James H Black, Gilbert R Upchurch, Kristina A Giles, Virendra I Patel, Marc L Schermerhorn
OBJECTIVE: Whereas sex differences in the pathogenesis, presentation, and outcomes of repair for abdominal aortic aneurysms are well studied, less is known about sex differences after thoracic endovascular aortic repair (TEVAR). The goal of this study was to evaluate the association between sex and morbidity and mortality after TEVAR. METHODS: A retrospective review of all TEVARs in the Society for Vascular Surgery Vascular Quality Initiative (VQI) registry from 2011 to 2015 was conducted, excluding those with dissection, trauma, and rupture...
March 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28258287/-trisegmental-fusion-by-vertebral-body-replacement-outcome-following-traumatic-multisegmental-fractures-of-the-thoracic-and-lumbar-spine
#20
Michael Kreinest, Dorothee Schmahl, Paul A Grützner, Stefan Matschke
BACKGROUND: Around 5% of all trauma patients suffer from spinal trauma. Spinal fractures are mainly located in the thoracic and lumbar spine. For multisegmental vertebral fractures categorized as instable, combined dorsal instrumentation and ventral stabilization is recommended. Numerous vertebral body replacement systems are available for ventral stabilization. OBJECTIVES: The aim of the current study was to analyze radiological results following the implantation of a hydraulic expandable vertebral body replacement and the evaluation of patients' outcome three years after implantation...
March 3, 2017: Der Unfallchirurg
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