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https://www.readbyqxmd.com/read/29668565/the-effects-of-genetic-3-mercaptopyruvate-sulfurtransferase-deficiency-in-murine-traumatic-hemorrhagic-shock
#1
Michael Gröger, Martin Wepler, Ulrich Wachter, Tamara Merz, Oscar McCook, Sandra Kress, Britta Lukaschewski, Sebastian Hafner, Markus Huber-Lang, Enrico Calzia, Michael Georgieff, Noriyuki Nagahara, Csaba Szabó, Peter Radermacher, Clair Hartmann
INTRODUCTION: Hemorrhagic shock is a major cause of death after trauma. An additional blunt chest trauma independently contributes to mortality upon the development of an acute lung injury (ALI) by aggravating pathophysiological consequences of hemorrhagic shock. The maintenance of hydrogen sulfide availability is known to play an important role during hemorrhage and ALI. We therefore tested the impact of a genetic 3-mercaptopyruvate sulfurtransferase mutation (Δ3-MST) in a resuscitated murine model of traumatic-hemorrhagic shock...
April 17, 2018: Shock
https://www.readbyqxmd.com/read/29661463/case-report-of-multiple-bilobar-hepatic-arterio-portal-fistulas-post-liver-transplantation-managed-conservatively
#2
Y Puri, P Srinivasan, P Peddu, N Heaton
Multiple intrahepatic arterio-portal fistulas are rare. The majority are isolated and occur secondary to liver trauma including iatrogenic interventions such as liver biopsy. Post-liver transplantation 18 cases have been reported, all secondary to an interventional radiological procedure. We report multiple bi-lobar arterio-portal fistulas in a liver transplant recipient recognized 1 year after transplantation. The donor died due to intracerebral bleeding following blunt head and abdominal trauma. In the present case, the etiology is not very clear...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29657728/can-we-predict-delayed-undesirable-events-after-blunt-injury-to-the-torso-visceral-organs
#3
Kenichiro Uchida, Yasumitsu Mizobata, Naohiro Hagawa, Tomonori Yamamoto, Shinichiro Kaga, Tomohiro Noda, Naoki Shinyama, Tetsuro Nishimura, Hiromasa Yamamoto
Aim: Blunt injuries to visceral organs have the potential to lead to delayed pseudoaneurysm formation or organ rupture, but current trauma and surgical guidelines do not recommend repetitive imaging. This study examined the incidence and timing of delayed undesirable events and established advisable timing for follow-up imaging and appropriate observational admission. Methods: Patients with blunt splenic (S), liver (L), or kidney (K) injury treated with non-operative management (NOM) in our institution were included and retrospectively reviewed...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29649020/autologous-bone-flap-resorption-years-after-subtemporal-craniotomy
#4
John Oladapo Obafunwa, Emily Hammerl, David Jaskierny, Livia Taylor, Lynette Russell, Karl Reinhard
In Spring of 2012, the partially undressed and skeletonized remains of a homeless adult Hispanic male was found in a fairly open wooded area in Nebraska. The remains showed evidence of extensive pathologies, which included healed traumas and surgeries. Examination of the decedent's medical records revealed that he had a history of kidney and liver problems, alcohol abuse, several traumas including a major head injury that necessitated a craniotomy, and radiological features of neurocysticercosis. The autologous bone flap, which was replaced after the craniotomy, had resorbed significantly away from the edges of the injury...
April 11, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29623230/hepatic-rupture-induced-by-spontaneous-intrahepatic-hematoma
#5
Jin-Bao Zhou, Wei-Bo Chen, Feng Zhu
The etiology of hepatic rupture is usually secondary to trauma, and hepatic rupture induced by spontaneous intrahepatic hematoma is clinically rare. We describe here a 61-year-old female patient who was transferred to our hospital with hepatic rupture induced by spontaneous intrahepatic hematoma. The patient had no history of trauma and had a history of systemic lupus erythematosus for five years, taking a daily dose of 5 mg prednisone for treatment. The patients experienced durative blunt acute right upper abdominal pain one day after satiation, which aggravated in two hours, accompanied by dizziness and sweating...
2018: Case Reports in Surgery
https://www.readbyqxmd.com/read/29622405/can-we-refine-the-management-of-blunt-liver-trauma
#6
L Barbier, M Calmels, M Lagadec, T Gauss, P-S Abback, F Cauchy, M Ronot, O Soubrane, C Paugam-Burtz
AIM: To describe the management of blunt liver injury and to study the potential relation between delayed complications, type of trauma mechanisms and liver lesions. PATIENTS AND METHODS: This is a retrospective single center study including 116 consecutive patients admitted with blunt liver injury between 2007 and 2015. RESULTS: Initial CT-scan identified an active bleeding in 33 (28%) patients. AAST (American Association for the Surgery of Trauma) grade was 1 to 3 in 82 (71%) patients and equal to 5 in 15 (13%) patients...
April 2, 2018: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29572673/laparoscopic-anatomical-liver-resection-after-complex-blunt-liver-trauma-a-case-report
#7
Arpad Ivanecz, Vid Pivec, Bojan Ilijevec, Saša Rudolf, Stojan Potrč
BACKGROUND: Various minimally invasive therapies are important adjuncts to management of hepatic injuries. However, there is a certain subset of patients who will benefit from liver resection, but there are no reports in the literature on laparoscopic anatomical liver resection for the management of complications after blunt liver trauma. CASE PRESENTATION: A 20-year-old male was admitted to the Emergency Unit of a tertiary referral center following a car accident...
March 23, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29569680/successful-non-operative-management-of-blunt-abdominal-trauma-in-highly-selective-cases-a-safe-and-effective-choice
#8
Georgios Theodoros Liagkos, Charalampos Spyropoulos, Gerasimos Tsourouflis, Aris Papadopoulos, Paulos Ioannides, Constantine Vagianos
BACKGROUND: The non-operative management (NOM) of abdominal injuries has gained wide acceptance over the last few decades. The present study evaluated the efficacy of NOM in blunt abdominal trauma (BAT) at a regional Hellenic hospital. METHODS: We analyzed the results of a pre-decided treatment protocol, which was applied to all patients hospitalized for BAT, from 2008 to 2015. The protocol proposed NOM in hemodynamically stable patients with no signs of peritonitis...
March 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29520416/assessment-of-sensitivity-of-whole-body-ct-for-major-trauma
#9
Susan Yoong, Ravi Kothari, Adam Brooks
INTRODUCTION: Whole body computed tomography has become standard practice in many centres in the management of severely injured trauma patients, however, the evidence for it's diagnostic accuracy is limited. AIM: To assess the sensitivity of whole body CT in major trauma. METHOD: Retrospective review of all patients with injury severity score (ISS) > 15 presenting with blunt trauma to a UK Major Trauma Centre between May 2012 and April 2014...
March 8, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29499671/posttraumatic-venous-gas-in-the-liver-a-case-report-and-review-of-the-current-literature
#10
René Fahrner, Falk Rauchfuss, Hubert Scheuerlein, Utz Settmacher
BACKGROUND: There are numerous causes of hepatic gas formation that range from serious pathologies to incidental findings, including mesenteric infarction, liver abscess, inflammatory bowel disease or minimally invasive hepatic interventions. CASE PRESENTATION: We report a case of a 50-year-old man who was admitted to the emergency room after a car accident. The clinical examination and further diagnostics revealed a craniocerebral injury with a fracture of the skull, concomitant soft tissue lesions and subarachnoidal bleeding...
March 2, 2018: BMC Surgery
https://www.readbyqxmd.com/read/29441442/internal-patterned-injuries-in-trauma
#11
Lucia Tattoli, Michael Tsokos, Claas Buschmann
Patterned bruising of the internal organs is unusual. In these cases a cutaneous pattern of bruising is not observed but the underlying tissue may show unusual injuries that may even be recognizable as a tramline pattern. We report the suicide of a 23-year-old man by jumping off a bridge. At autopsy, an unusual finding was "tramline" bruising of the right liver lobe. The "blunt objects" that inflicted the bruising were determined to be the right ribs which were pushed against the liver capsule as a consequence of the extensive thoracic and vertebral trauma after a fall from a height with intermediate impact...
February 13, 2018: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/29437722/transudative-chylothorax-an-uncommon-illness-due-to-a-common-cause
#12
Arindam Mukherjee, Inderpaul Singh Sehgal, Bhagwant Rai Mittal, Sahajal Dhooria
Chylothorax is defined as presence of chyle in the pleural space. It is commonly associated with cardiothoracic surgery, trauma, malignancy or some benign disorders. Transudative chylothorax is uncommon. A 52-year-old man presented with bilateral chylothorax with preceding history of blunt trauma to the chest. On further evaluation, he was diagnosed to have a transudative chylothorax due to cirrhosis of liver with coexisting chylous ascites and evidence of peritoneopleural communication. The patient was managed with diuretics followed by chemical pleurodesis with iodopovidone...
February 7, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29428102/liver-trauma-what-current-management
#13
Mohamed Tarchouli, Mohamed Elabsi, Noureddine Njoumi, Mohamed Essarghini, Mahjoub Echarrab, Mohamed Rachid Chkoff
BACKGROUND: The liver is the most commonly damaged organ in abdominal trauma. The management of liver trauma has experienced many changes over the last two decades. Currently there is a trend toward a non-operative treatment warranted by the successful pediatric experience and better results recorded in many trauma centers worldwide. This study aimed to evaluate outcomes of operative and non-operative management of liver trauma in our institution over the last five years. METHODS: The patients with a diagnosis of blunt or penetrating liver injuries, admitted and managed in our hospital from January 2012 to December 2016 were retrospectively studied...
February 2018: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/29420582/ethyl-pyruvate-ameliorates-hepatic-injury-following-blunt-chest-trauma-and-hemorrhagic-shock-by-reducing-local-inflammation-nf-kappab-activation-and-hmgb1-release
#14
Nils Wagner, Scott Dieteren, Niklas Franz, Kernt Köhler, Katharina Mörs, Luka Nicin, Julia Schmidt, Mario Perl, Ingo Marzi, Borna Relja
BACKGROUND: The treatment of patients with multiple trauma including blunt chest/thoracic trauma (TxT) and hemorrhagic shock (H) is still challenging. Numerous studies show detrimental consequences of TxT and HS resulting in strong inflammatory changes, organ injury and mortality. Additionally, the reperfusion (R) phase plays a key role in triggering inflammation and worsening outcome. Ethyl pyruvate (EP), a stable lipophilic ester, has anti-inflammatory properties. Here, the influence of EP on the inflammatory reaction and liver injury in a double hit model of TxT and H/R in rats was explored...
2018: PloS One
https://www.readbyqxmd.com/read/29350250/-abdominal-injuries-in-polytraumatized-adults-systematic-review
#15
C E M Pothmann, K Sprengel, H Alkadhi, G Osterhoff, F Allemann, T Jentzsch, G Jukema, H C Pape, H-P Simmen, V Neuhaus
Abdominal injuries are potentially life-threatening and occur in 20-25% of all polytraumatized patients. Blunt trauma is the main mechanism. The liver and spleen are most commonly injured and much less often the intestines. The clinical evaluation proves equivocal in many cases; therefore, the gold standard is computed tomography (CT), which has been increasingly used even in hemodynamically weakly stable or sometimes even unstable patients because it promptly provides precise diagnostic findings, which present the basis for successful therapy...
February 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29283968/transfer-and-nontransfer-patients-in-isolated-low-grade-blunt-pediatric-solid-organ-injury-implications-for-regionalized-trauma-systems
#16
Robert A Tessler, Vivian H Lyons, Judith C Hagedorn, Monica S Vavilala, Adam Goldin, Saman Arbabi, Frederick P Rivara
BACKGROUND: Regionalization of trauma care is a national priority and hospitalization for blunt abdominal trauma, which may include transfer, is common among children. The objective of this study was to determine whether there were differences in mortality, treatment, or length of stay between patients treated at or transferred to a higher level trauma center and those not transferred and admitted to a lower level trauma center. METHODS: Cohort from Washington state trauma registry from 2000 to 2014 of patients 16 years or younger with isolated Grade I-III spleen, liver, or kidney injury...
April 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29259232/cardiac-depression-in-pigs-after-multiple-trauma-characterization-of-posttraumatic-structural-and-functional-alterations
#17
M Kalbitz, S Schwarz, B Weber, B Bosch, J Pressmar, F M Hoenes, C K Braun, K Horst, T P Simon, R Pfeifer, P Störmann, H Hummler, F Gebhard, H C Pape, M Huber-Lang, F Hildebrand
The purpose of this study was to define the relationship between cardiac depression and morphological and immunological alterations in cardiac tissue after multiple trauma. However, the mechanistic basis of depressed cardiac function after trauma is still elusive. In a porcine polytrauma model including blunt chest trauma, liver laceration, femur fracture and haemorrhage serial trans-thoracic echocardiography was performed and correlated with cellular cardiac injury as well as with the occurrence of extracellular histones in serum...
December 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29245362/characteristics-of-computed-tomography-in-hemodynamically-unstable-blunt-trauma-patients-experience-at-a-tertiary-care-center
#18
Youn-Jung Kim, June-Sung Kim, Soo-Han Cho, Jun-Il Bae, Chang Hwan Sohn, Yoon-Seon Lee, Jae-Ho Lee, Kyoung-Soo Lim, Won Young Kim
Emergent exploratory laparotomy is recommended for hemodynamically unstable blunt trauma patients suspected of having hemoperitoneum. However, given the unreliability of ultrasonography and rapid scan speed of computed tomography (CT), CT might help clinicians provide accurate information even in hemodynamically unstable trauma patients. This observational study aimed to describe the bleeding site and hospital course of severe blunt trauma patients with hemoperitoneum diagnosed by CT scan.We enrolled all consecutive adult blunt trauma patients (≥18 years old) who underwent whole-body CT before operation between February 2012 and October 2016...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29224654/evaluation-and-management-of-blunt-solid-organ-trauma
#19
REVIEW
Jonathan G Martin, Jay Shah, Craig Robinson, Sean Dariushnia
Trauma is a leading cause of death in patients under the age of 45 and generally associated with a high kinetic energy event such as a motor vehicle accident or fall from extreme elevations. Blunt trauma can affect every organ system and major vascular structure with potentially devastating effect. When we consider abdominal solid organ injury from blunt trauma, we usually think of the liver, spleen, and kidneys. However, all of the abdominal organs, including the pancreas and adrenal glands, may be involved...
December 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29221814/use-of-interventional-radiology-as-initial-hemorrhage-control-to-improve-outcomes-for-potentially-lethal-multiple-blunt-injuries
#20
Hiroyuki Otsuka, Toshiki Sato, Keiji Sakurai, Hiromichi Aoki, Takeshi Yamagiwa, Shinichi Iizuka, Sadaki Inokuchi
INTRODUCTION: Recently, trauma management has been markedly improved with interventional radiology (IVR) and damage-control strategies. However, the indications for its use in hemodynamically unstable patients with severe trauma remains unclear. In some cases, IVR may be more effective than surgery for damage-control hemostasis; however, performing IVR in life-threatening trauma settings is challenging. To address this, we practiced and evaluated a trauma-management system with emergency physicians who trained for both severe trauma management, and techniques of surgery and IVR...
February 2018: Injury
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