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https://www.readbyqxmd.com/read/28980061/applications-of-contrast-enhanced-ultrasound-in-the-pediatric-abdomen
#1
Aikaterini Ntoulia, Sudha A Anupindi, Kassa Darge, Susan J Back
Contrast-enhanced ultrasound (CEUS) is a radiation-free, safe, and in specific clinical settings, highly sensitive imaging modality. Over the recent decades, there is cumulating experience and a large volume of published safety and efficacy data on pediatric CEUS applications. Many of these applications have been directly translated from adults, while others are unique to the pediatric population. The most frequently reported intravenous abdominal applications of CEUS in children are the characterization of focal liver lesions, monitoring of solid abdominal tumor response to treatment, and the evaluation of intra-abdominal parenchymal injuries in selected cases of blunt abdominal trauma...
October 4, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28975653/analysis-of-skeletal-muscle-microcirculation-in-a-porcine-polytrauma-model-with-haemorrhagic-shock
#2
Zhi Qiao, Klemens Horst, Michel Teuben, Johannes Greven, Luxu Yin, Yannik Kalbas, René H Tolba, Hans-Christoph Pape, Frank Hildebrand, Roman Pfeifer
Polytraumatised patients with haemorrhagic shock are prone to develop systemic complications, such as SIRS (systemic inflammatory response syndrome), ARDS (acute respiratory distress syndrome) and MOF (multiple organ failure). The pathomechanism of severe complications following trauma is multifactorial, and it is believed that microcirculatory dysfunction plays an important role. The aim of this study was to determine the changes in the microcirculation in musculature over time during shock and subsequent resuscitation in a porcine model of haemorrhagic shock and polytrauma...
October 3, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28968251/hypothermia-does-not-influence-liver-damage-and-function-in-a-porcine-polytrauma-model
#3
D Eschbach, K Horst, M Sassen, J Andruszkow, J Mohr, F Debus, N Vogt, T Steinfeldt, F Hildebrand, K Schöller, E Uhl, H Wulf, S Ruchholtz, H Pape, M Frink
BACKGROUND: Previous studies revealed evidence that induced hypothermia attenuates ischemic organ injuries after severe trauma. In the present study, the effect of hypothermia on liver damage was investigated in a porcine long term model of multi-system injury, consisting of blunt chest trauma, penetrating abdominal trauma, musculoskeletal injury, and hemorrhagic shockMETHODS: In 30 pigs, a standardized polytrauma including blunt chest trauma, penetrating abdominal trauma, musculoskeletal injury, and hemorrhagic shock of 45% of total blood volume was induced...
September 15, 2017: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/28941929/minimizing-variance-in-care-of-pediatric-blunt-solid-organ-injury-through-utilization-of-a-hemodynamic-driven-protocol-a-multi-institution-study
#4
Aaron J Cunningham, Katrine M Lofberg, Sanjay Krishnaswami, Marilyn W Butler, Kenneth S Azarow, Nicholas A Hamilton, Elizabeth A Fialkowski, Pamela Bilyeu, Erika Ohm, Erin C Burns, Margo Hendrickson, Preetha Krishnan, Cynthia Gingalewski, Mubeen A Jafri
BACKGROUND: An expedited recovery protocol for management of pediatric blunt solid organ injury (spleen, liver, and kidney) was instituted across two Level 1 Trauma Centers, managed by nine pediatric surgeons within three hospital systems. METHODS: Data were collected for 18months on consecutive patients after protocol implementation. Patient demographics (including grade of injury), surgeon compliance, National Surgical Quality Improvement Program (NSQIP) complications, direct hospital cost, length of stay, time in the ICU, phlebotomy, and re-admission were compared to an 18-month control period immediately preceding study initiation...
September 4, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28932700/endovascular-management-of-arterial-injuries-after-blunt-or-iatrogenic-renal-trauma
#5
REVIEW
Romaric Loffroy, Olivier Chevallier, Sophie Gehin, Marco Midulla, Pierre-Emmanuel Berthod, Christophe Galland, Pascale Briche, Céline Duperron, Nabil Majbri, Christiane Mousson, Nicolas Falvo
The kidney is the third most common abdominal organ to be injured in trauma, following the spleen and liver, respectively. The most commonly used classification scheme is the American Association for the Surgery of Trauma (AAST) classification of blunt renal injuries, which grades renal injury according to the size of laceration and its proximity to the renal hilum. Arteriovenous fistula and pseudoaneurysm are the most common iatrogenic biopsy-related or surgery-related vascular injuries in native kidneys. The approach to renal artery injuries has changed over time from more aggressive intervention to more conservative observational or endovascular management, including selective transcatheter arterial embolization (TAE) and the placement of stents/stent grafts...
August 2017: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28930966/bilateral-pulmonary-emboli-and-extensive-inferior-vena-cava-thrombosis-in-the-setting-of-large-subcapsular-hematoma-and-liver-laceration-after-blunt-trauma
#6
Alejandro Betancourt-Ramirez, Soraya SMolero, Patrizio Petrone, Corrado P Marini, Heidi L Frankel
No abstract text is available yet for this article.
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28898314/-associated-factors-to-non-operative-management-failure-of-hepatic-and-splenic-lesions-secondary-to-blunt-abdominal-trauma-in-children
#7
Adriana Echavarria Medina, Carlos Hernando Morales Uribe, Luis Guillermo Echavarria R, Viviana María Vélez Marín, Jorge Alberto Martínez Montoya, David Fernando Aguillón
INTRODUCTION: The non operative management (NOM) is the standard management of splenic and liver blunt trauma in pediatric patients.Hemodynamic instability and massive transfusions have been identified as management failures. Few studies evaluate whether there exist factors allowing anticipation of these events. The objective was to identify factors associated with the failure of NOM in splenic and liver injuries for blunt abdominal trauma. PATIENTS AND METHOD: Retrospective analysis between 2007-2015 of patients admitted to the pediatric surgery at University Hospital Saint Vincent Foundation with liver trauma and/or closed Spleen...
2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28886723/pancreatic-injury-in-children-a-case-report-and-review-of-the-literature
#8
Fayza Haider, Mohammed Amin Al Awadhi, Eizat Abrar, Mooza Al Dossari, Hasan Isa, Husain Nasser, Hakima Al Hashimi, Sharif Al Arayedh
BACKGROUND: Trauma is the main cause of morbidity and mortality in the pediatric population. Blunt trauma to the abdomen accounts for the majority of abdominal injuries in children. Pancreatic injury, although uncommon (2 to 9%), is the fourth most common solid organ injury. Unlike other solid organ injuries, pancreatic trauma may be subtle and difficult to diagnose. Computed tomography currently is the imaging modality of choice. As the incidence of pancreatic injury in children sustaining blunt abdominal trauma is low, management remains a challenge...
September 9, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28867641/a-comparison-of-the-management-of-blunt-splenic-injury-in-children-and-young-people-a-new-south-wales-population-based-retrospective-study
#9
Susan E Adams, Andrew Holland, Julie Brown
The importance and safety of non-operative management (NOM) of Blunt Splenic Injury (BSI) has been established in children and adults over recent decades. However, studies have shown higher operation rates in adults. There is international evidence that when children are managed in adult centres, operation rates are higher while adolescents in paediatric centres, are operated on in line with paediatric guidelines. This difference between children and young adults, and the factors responsible, have not been examined in New South Wales (NSW)...
August 14, 2017: Injury
https://www.readbyqxmd.com/read/28857806/reversing-dabigatran-anticoagulation-with-prothrombin-complex-concentrate-versus-idarucizumab-as-part-of-multimodal-hemostatic-intervention-in-an-animal-model-of-polytrauma
#10
Markus Honickel, Till Braunschweig, Rolf Rossaint, Christian Stoppe, Hugo Ten Cate, Oliver Grottke
BACKGROUND: Although idarucizumab is the preferred treatment for urgent dabigatran reversal, it is not always available. Prothrombin complex concentrate (PCC) may be an alternative and, with bleeding in trauma, additional hemostatic therapy may be required. The authors investigated multimodal treatment in a preclinical polytrauma model. METHODS: Dabigatran etexilate (30 mg/kg twice daily) was given orally to 45 male pigs for 3 days. On day 4, animals received a dabigatran infusion before blunt liver injury and bilateral femur fractures...
November 2017: Anesthesiology
https://www.readbyqxmd.com/read/28855777/characteristics-and-management-of-blunt-renal-injury-in-children
#11
Yuichi Ishida, Alan H Tyroch, Nader Emami, Susan F McLean
BACKGROUND: Renal trauma in the pediatric population is predominately due to blunt mechanism of injury. Our purpose was to determine the associated injuries, features, incidence, management, and outcomes of kidney injuries resulting from blunt trauma in the pediatric population in a single level I trauma center. METHODS: This was a retrospective chart and trauma registry review of all pediatric blunt renal injuries at a regional level I trauma center that provides care to injured adults and children...
July 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28852464/missed-diagnosis-of-a-large-right-sided-diaphragmatic-rupture-with-herniated-liver-and-concomitant-liver-laceration-after-blunt-trauma-consequences-for-delayed-surgical-repair
#12
Kjetil Søreide, Andreas Reite, Rune Haaverstad
Diaphragmatic injuries are relatively rare and as such frequently missed, particularly if they occur as a rare event on the right-sided dome. Even if detected in the early phase, the concomitant injury of other organs may delay the time to repair. The delay in surgical correction may aggravate additional adherences between thoracic and abdominal organs and cause the diaphragmatic muscle to retract, causing a larger tissue defect that may prevent primary suture repair. This should be taken into consideration when choosing access to repair (thoracic, abdominal or both cavities), mode (open or laparoscopic) and type of repair (primary suture or use of mesh material to close the defect)...
August 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28665831/an-unusual-medicolegal-case-of-32-year-old-mother-and-her-29-week-fetus-with-hemolysis-elevated-liver-enzymes-and-low-platelet-count-syndrome-case-report-and-short-literature-review
#13
REVIEW
Michał Szeremeta, Petra Drobuliakova, Jerzy Przepieść, Janusz Załuski, Adam Sackiewicz, Anna Niemcunowicz-Janica
Forensic medicine experts are well aware of blunt abdominal trauma, which often lead to death because of serious internal organ injury with severe blood loss. Sometimes careful examination of such cases may reveal some other underlying conditions, such as an existing disease that had contributed to the death or life-threatening complications. Our article presents a rare case of spontaneous hepatic rupture and intraperitoneal hemorrhage in a 32-year-old primigravida and her 29-week fetus, which was a result of hemolysis, elevated liver enzymes, and low platelet count syndrome...
September 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28659680/isolated-double-gastric-perforation-in-blunt-abdominal-trauma-a-case-report
#14
Husain M Gheewala, Snehajit Wagh, Surajsinh A Chauhan, Sonam M Devlekar, Shruti Bhave, Dharmesh J Balsarkar
Blunt abdominal trauma mostly results from motor vehicle accidents, recreational accidents, falls or assaults with commonly injured internal organs being the spleen, liver, retroperitoneum, small bowel, kidneys, bladder, colorectal, diaphragm and pancreas. Gastric rupture is quite uncommon. Isolated gastric perforations following blunt trauma to the abdomen are mostly seen in paediatric patients. It is uncommon in adult patients and even rarer is the occurrence of double gastric perforations. We report here with a case of isolated double gastric perforation in a 24-year-old male patient following vehicular accident...
June 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28659673/emergency-laparotomies-at-a-tertiary-care-center-a-hospital-based-cross-sectional-study
#15
G Gejoe, Induprabha Yadev, M Rahul
Emergency laparotomy is a common high-risk surgical procedure, but with a few outcome data and few data on postoperative care. This was a hospital-based descriptive study of 376 consecutive emergency midline laparotomies performed in a tertiary care center. The aim of the study was to identify the clinical presentation, surgical indications, preoperative delay, intraoperative findings, and postoperative complications. Majority of the patients belonged to the 40-80-year age group. Broadly, the indications could be divided into acute abdomen and trauma...
June 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28644311/hemobilia-an-uncommon-but-notable-cause-of-upper-gastrointestinal-bleeding
#16
Scott Cathcart, John W Birk, Michael Tadros, Micheal Schuster
GOAL AND BACKGROUND: A literature review to improve practitioners' knowledge and performance concerning the epidemiology, diagnosis, and management of hemobilia. STUDY: A search of Pubmed, Google Scholar, and Medline was conducted using the keyword hemobilia and relevant articles were reviewed and analyzed. The findings pertaining to hemobilia etiology, investigation, and management techniques were considered and organized by clinicians practiced in hemobilia. RESULTS: The majority of current hemobilia cases have an iatrogenic cause from either bile duct or liver manipulation...
October 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28614141/role-of-hemorrhagic-shock-in-experimental-polytrauma
#17
Stephanie Denk, Sebastian Weckbach, Philipp Eisele, Christian K Braun, Rebecca Wiegner, Julia J Ohmann, Lisa Wrba, Felix M Hoenes, Philipp Kellermann, Peter Radermacher, Ulrich Wachter, Sebastian Hafner, Oscar McCook, Anke Schultze, Annette Palmer, Sonja Braumüller, Florian Gebhard, Markus Huber-Lang
Hemorrhagic shock (HS) after tissue trauma increases the complication and mortality rate of polytrauma (PT) patients. Although several murine trauma models have been introduced, there is a lack of knowledge about the exact impact of an additional HS. We hypothesized that HS significantly contributes to organ injury, which can be reliably monitored by detection of specific organ damage markers.Therefore we established a novel clinically relevant PT plus HS model in C57BL/6 mice which were randomly assigned to control, HS, PT or PT+HS procedure (n = 8 per group)...
June 13, 2017: Shock
https://www.readbyqxmd.com/read/28612150/single-versus-multiple-solid-organ-injuries-following-blunt-abdominal-trauma
#18
Ayman El-Menyar, Husham Abdelrahman, Ammar Al-Hassani, Ruben Peralta, Hiba AbdelAziz, Rifat Latifi, Hassan Al-Thani
BACKGROUND: We aimed to describe the pattern of solid organ injuries (SOIs) and analyze the characteristics, management and outcomes based on the multiplicity of SOIs. METHODS: A retrospective study in a Level 1 trauma center was conducted and included patients admitted with blunt abdominal trauma between 2011 and 2014. Data were analyzed and compared for patients with single versus multiple SOIs. RESULTS: A total of 504 patients with SOIs were identified with a mean age of 28 ± 13 years...
November 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28604373/blunt-hepatic-and-splenic-trauma-a-single-center-experience-using-a-multidisciplinary-protocol
#19
Paolo Ruscelli, Farncesco Buccoliero, Susanna Mazzocato, Giulio Belfiori, Claudio Rabuini, Pierluigi Sperti, Massimiliano Rimini
AIM: The aim of this retrospective study was to describe more than 10 years experience of a single Trauma Center about non operative management of abdominal organ injuries in hemodynamically stable patients MATERIAL OF STUDY: Between January 2001 and December 2014 ,732 consecutive patients were admitted with blunt abdominal trauma, involving liver and/or spleen and/or kidney, at the Bufalini Cesena Hospital .Management of patients included a specific institutional developed protocol :hemodynamic stability was evaluated in shock room according to the patients response to fluid challenge and the patients were classified into three categories A,B,and C...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28596799/the-rate-of-success-of-the-conservative-management-of-liver-trauma-in-a-developing-country
#20
S Buci, M Torba, A Gjata, I Kajo, Gj Bushi, K Kagjini
BACKGROUND: The conservative treatment of liver trauma has made important progress over the last 10 years at the Trauma University Hospital in Tirana, Albania. The percentage of success was 58.7%. The aims of this study were to analyze the conservative treatment of liver trauma and to compare the results with those in the literature. METHODS: This study was conducted prospectively from January 2009 to December 2012. We analyzed 173 patients admitted to our hospital with liver trauma...
2017: World Journal of Emergency Surgery: WJES
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