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blunt chest trauma

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https://www.readbyqxmd.com/read/29330983/ultrasound-and-supine-chest-radiograph-in-road-traffic-accident-patients-a-reliable-and-convenient-way-to-diagnose-pleural-effusion
#1
Uzma Mumtaz, Zainab Zahur, Muhammad Ali Raza, Madiha Mumtaz
BACKGROUND: Portable bed side ultrasound and supine chest radiograph of 80 traumatic patients excluding very clinically unstable patients who subsequently underwent CT scan chest was done for traumatic effusion showing that ultrasound had a higher sensitivity than CXR, 88.23% and 77.94%, respectively, and a similar specificity of 100% and 100%, respectively. Objective of the study is to compare the diagnostic accuracy of high resolution ultrasound and supine chest x-ray in detection of pleural effusion in road traffic accident patients keeping plain CT chest as gold standard...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29322585/scapular-fractures-in-the-pan-scan-era
#2
Cortlyn Brown, Karim Elmobdy, Ali S Raja, Robert M Rodriguez
BACKGROUND: Scapular fractures have been traditionally taught to be associated with significant injuries and major morbidity. As we demonstrated with sternal fracture, pulmonary contusion and rib fracture, increased chest CT utilization and head-to-pelvis CT (pan-scan) protocols in blunt trauma evaluation, however, may diagnose minor, clinically irrelevant scapular fractures, possibly rendering previous teachings obsolete. OBJECTIVES: To determine the 1) percentages of scapular fractures seen on chest CT only (SOCTO) versus seen on both CXR and CT and of isolated scapular fracture (scapular fracture without other thoracic injuries), 2) frequencies of associated thoracic injury with scapular fracture, and 3) proportion of patients admitted, mortality, hospital length of stay, and injury severity scores (ISS), comparing four patient groups: scapular fracture, non-scapular fracture, scapular fracture SOCTO, and isolated scapular fracture...
January 11, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29310701/severe-thoracic-trauma-still-an-independent-predictor-for-death-in-multiple-injured-patients
#3
Michael Grubmüller, Maximilian Kerschbaum, Eva Diepold, Katharina Angerpointner, Michael Nerlich, Antonio Ernstberger
BACKGROUND: Over the past, the severe thoracic trauma has had decisive influence on the outcome of multiple injured patients. Today, new therapies (e.g. extracorporeal membrane oxygenation (ECMO), protective ventilation methods and new forms of patient positioning) are available and applied regularly. What impact on the patient's outcome does the thoracic trauma have today? METHODS: Prospective data collection of multiple injured patients in a level-I trauma center was performed between 2008 and 2014...
January 8, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29306264/management-of-right-main-bronchial-rupture-with-a-double-lumen-endotracheal-tube-in-a-patient-with-blunt-chest-trauma
#4
Seung Hwan Seol, Woon Jeong Lee, Seon Hee Woo, Dae Hui Kim, Jong Hui Suh
Tracheobronchial disruption is one of the most severe injuries caused by blunt chest trauma. It may cause airway obstruction and resulting life-threatening respiratory deficiency. However, the clinical presentations are variable and frequently difficult to diagnose. We report a case of a previously healthy 16-year-old man with complete right main bronchial transection sustained after a vehicular accident, who had progressive dyspnea, subcutaneous emphysema in the neck and anterior chest wall, and bilateral tension pneumothorax...
December 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29305713/the-benefit-of-ultrasound-in-deciding-between-tube-thoracostomy-and-observative-management-in-hemothorax-resulting-from-blunt-chest-trauma
#5
Meng-Hsuan Chung, Chen-Yuan Hsiao, Nai-Shin Nian, Yen-Chia Chen, Chien-Ying Wang, Yi-Szu Wen, Hsin-Chin Shih, David Hung-Tsang Yen
BACKGROUND: Hemothorax is most commonly resulted from a closed chest trauma, while a tube thoracostomy (TT) is usually the first procedure attempted to treat it. However, TT may lead to unexpected results and complications in some cases. The advantage of thoracic ultrasound (TUS) over a physical examination combined with chest radiograph (CXR) for diagnosing hemothorax1 has been proposed previously. However, its benefits in terms of avoiding non-therapeutic TT have not yet been confirmed...
January 5, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29305711/early-management-of-retained-hemothorax-in-blunt-head-and-chest-trauma
#6
Fong-Dee Huang, Wen-Bin Yeh, Sheng-Shih Chen, Yuan-Yuarn Liu, I-Yin Lu, Yi-Pin Chou, Tzu-Chin Wu
BACKGROUND: Major blunt chest injury usually leads to the development of retained hemothorax and pneumothorax, and needs further intervention. However, since blunt chest injury may be combined with blunt head injury that typically requires patient observation for 3-4 days, other critical surgical interventions may be delayed. The purpose of this study is to analyze the outcomes of head injury patients who received early, versus delayed thoracic surgeries. MATERIALS AND METHODS: From May 2005 to February 2012, 61 patients with major blunt injuries to the chest and head were prospectively enrolled...
January 5, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29289269/myocardial-infarction-secondary-to-blunt-chest-trauma
#7
Tariq S Marroush, Amreeta V Sharma, Louis D Saravolatz, Robert Takla, Howard S Rosman
Myocardial infarction (MI) following blunt chest trauma is rare, but potentially fatal. We treated a young patient for acute MI after falling chest-first on ice while playing hockey. Coronary artery bypass grafting (CABG) was performed after percutaneous stenting attempts were unsuccessful. By reviewing the related literature, we found 179 cases, the majority of which affected young males following road accidents. Left anterior descending artery was most frequently affected followed by right coronary artery particularly in their proximal thirds...
January 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29278540/a-case-of-fatal-cerebral-air-embolism-after-blunt-lung-trauma-postmortem-computed-tomography-and-autopsy-findings
#8
Isabella Mercurio, Daniele Capano, Riccardo Torre, Aldo Taddei, Gianmarco Troiano, Michele Scialpi, Mario Gabbrielli
Cerebral air embolism is caused by gas bubbles in the vascular system. These bubbles can cause cerebral ischemia by obstructing encephalic blood vessels. It is frequently associated with blunt and penetrating chest trauma as well as iatrogenic interventions. Lung trauma involving laceration of the respiratory tract, lung parenchyma, and blood vessels may result in direct communication of these structures, driving air or gas into the pulmonary venous system. We report a case of a blunt chest trauma that led to massive arterial air embolism that was possible to recognize with the help of postmortem computed tomographic scan examination...
December 22, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29261721/the-multistep-road-to-ventilator-associated-lung-abscess-a-retrospective-study-of-s-aureus-ventilator-associated-pneumonia
#9
Roman Mounier, David Lobo, Julia Voulgaropoulos, Mathieu Martin, Bouziane Aït-Mamar, Valérie Bitot, Paul-Henri Jost, Ron Birnbaum, Biba Nebbad, Fabrice Cook, Gilles Dhonneur
OBJECT: We observed some cases of lung abscess (LA) in ICU patients suffering S.aureus ventilator-associated pneumonia (S.aureus-VAP). We aimed to assess which of the host and/or bacteria-related features are associated with LA. METHODS: We conducted a retrospective study from January 2009 to July 2013 in a trauma surgical ICU within a teaching hospital. All adult patients presenting with S.aureus-VAP were included. We compared two groups of patients according to the formation or not of LA concomitantly to S...
2017: PloS One
https://www.readbyqxmd.com/read/29259232/cardiac-depression-in-pigs-after-multiple-trauma-characterization-of-posttraumatic-structural-and-functional-alterations
#10
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/29249785/-successful-early-surgical-treatment-for-infected-traumatic-pulmonary-pseudocyst
#11
Masashi Goto, Katsuhiko Aoyama, Erina Seki, Akihiro Shimotakahara, Hikaru Watarai, Tomoki Hirose, Manabu Shimoda, Takayuki Haga
Almost all traumatic pulmonary pseudocysts (TPP), such as cavitary pulmonary lesions after blunt chest trauma, resolve spontaneously. On the contrary, secondary infection of a TPP should be considered in the presence of purulent sputum or hemosputum and a persistent cavity. We report a case of an infected TPP that was successfully treated by early surgical treatment. A 25-year-old man was transferred to our hospital with a TPP, shown by computed tomography (CT) as having a thick-walled large cavity, after the acute phase of blunt chest trauma...
December 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29232735/clinical-outcome-of-urgent-thoracotomy-in-patients-with-penetrating-and-blunt-chest-trauma-a-retrospective-survey
#12
Yael Refaely, Leonid Koyfman, Michael Friger, Leonid Ruderman, Mahmud Abu Saleh, Gidon Sahar, Gad Shaked, Moti Klein, Evgeni Brotfain
No abstract text is available yet for this article.
December 12, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29226380/acute-severe-mitral-regurgitation-after-blunt-chest-trauma
#13
Petar Saric, Benjamin D Ravaee, Toral R Patel, Brian D Hoit
Myocardial contusion and aortic injury are well-known cardiac complications of blunt chest trauma, but valvular injury is rare. Traumatic valve injuries most commonly involve the aortic valve, with isolated mitral valve injury being quite rare. We report a case of acute severe mitral regurgitation due to ruptured chordae tendineae requiring surgical repair following a motor vehicle accident.
December 11, 2017: Echocardiography
https://www.readbyqxmd.com/read/29223534/systemic-recovery-and-therapeutic-effects-of-transplanted-allogenic-and-xenogenic-mesenchymal-stromal-cells-in-a-rat-blunt-chest-trauma-model
#14
Elisa Maria Amann, Markus Thomas Rojewski, Sinja Rodi, Daniel Fürst, Jörg Fiedler, Annette Palmer, Sonja Braumüller, Markus Huber-Lang, Hubert Schrezenmeier, Rolf Erwin Brenner
BACKGROUND: Effective therapy of Acute Lung Injury (ALI) is still a major scientific and clinical problem. To define novel therapeutic strategies for sequelae of blunt chest trauma (TxT) like ALI/Acute Respiratory Distress Syndrome, we have investigated the immunomodulatory and regenerative effects of a single dose of ex vivo expanded human or rat mesenchymal stromal cells (hMSCs/rMSCs) with or without priming, immediately after the induction of TxT in Wistar rats. METHODS: We analyzed the histological score of lung injury, the cell count of the broncho alveolar lavage fluid (BAL), the change in local and systemic cytokine level and the recovery of the administered cells 24 h and 5 days post trauma...
December 6, 2017: Cytotherapy
https://www.readbyqxmd.com/read/29203574/blunt-chest-trauma-a-clinical-chameleon
#15
REVIEW
Kaveh Eghbalzadeh, Anton Sabashnikov, Mohamed Zeriouh, Yeong-Hoon Choi, Alexander C Bunck, Navid Mader, Thorsten Wahlers
The incidence of blunt chest trauma (BCT) is greater than 15% of all trauma admissions to the emergency departments worldwide and is the second leading cause of death after head injury in motor vehicle accidents. The mortality due to BCT is inhomogeneously described ranging from 9% to 60%. BCT is commonly caused by a sudden high-speed deceleration trauma to the anterior chest, leading to a compression of the thorax. All thoracic structures might be injured as a result of the trauma. Complex cardiac arrhythmia, heart murmurs, hypotension, angina-like chest pain, respiratory insufficiency or distention of the jugular veins may indicate potential cardiac injury...
December 4, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29199182/delayed-diagnosis-and-treatment-of-high-grade-blunt-pancreatic-trauma-case-report-and-review-of-literature
#16
Myftar Torba, Arben Gjata, Francesco Rulli, Ilir Kajo, Sotir Ceka, Tajar Asqeri
INTRODUCTION: Despite technological advancement, high grade pancreatic injuries following blunt abdominal trauma continues to remain a disease that is associated with high morbidity and mortality rates, particularly in cases of delayed diagnosis. The aim of this paper was the presentation of delayed diagnosis and treatment peculiarities of high grade pancreatic trauma and a review of literature. CASE REPORT: A 55-years old man, involved in motor vehicle crashes, was referred to our level I trauma center...
November 29, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29194339/risk-factors-for-the-development-of-acute-respiratory-distress-syndrome-following-hemorrhage
#17
Bryce R H Robinson, Mitchell J Cohen, John B Holcomb, Timothy A Pritts, Dina Gomaa, Erin E Fox, Richard D Branson, Rachael A Callcut, Bryan A Cotton, Martin A Schreiber, Karen J Brasel, Jean-Francois Pittet, Kenji Inaba, Jeffery D Kerby, Thomas M Scalea, Charlie E Wade, Eileen M Bulger
BACKGROUND: The Pragmatic Randomized Optimal Platelet and Plasma Ratios (PROPPR) study evaluated the effects of plasma and platelets on hemostasis and mortality after hemorrhage. The pulmonary consequences of resuscitation strategies that mimic whole blood, remain unknown. METHODS: A secondary analysis of the PROPPR study was performed. Injured patients predicted to receive a massive transfusion were randomized to 1:1:1 vs. 1:1:2 plasma-platelet-RBC ratios at 12 Level I North American trauma centers...
November 30, 2017: Shock
https://www.readbyqxmd.com/read/29191668/non-operative-management-is-feasible-for-selected-blunt-trauma-patients-with-pericardial-effusion
#18
Jen-Fu Huang, Feng-Jen Hsieh, Chih-Yuan Fu, Chien-Hung Liao
BACKGROUND: Blunt pericardial effusion (BPE) in trauma patients can be suggestive of injuries to the heart or great vessels. Surgical exploration is the mainstay of management; however, the effectiveness of non-operative management in this patient group remains unclear. METHODS: Patients presenting with BPE in the trauma registry system at our level I trauma center were reviewed. Patients with and without cardiovascular (CVS) injury were compared to identify predictors for CVS injury and to understand the factors related to the requirement for surgery...
November 26, 2017: Injury
https://www.readbyqxmd.com/read/29187218/open-stent-graft-repair-with-upper-half-sternotomy-for-blunt-thoracic-aortic-injury-a-case-report
#19
Toshinori Komatsu, Tamaki Takano, Hiromu Kehara, Megumi Fuke, Takamitsu Terasaki, Masayuki Sakaguchi
BACKGROUND: Thoracic endovascular aortic repair is now widely applied to the treatment of blunt aortic injury. However, its long-term outcomes remain unclear. Endoleakage and migration might occur in the long term, especially when younger patients undergo endovascular aortic repair. In open stent grafting, the proximal end of the open stent graft is directly sutured to the native aorta, which may reduce the risk of endoleakage and migration. We applied open stent grafting to the treatment of blunt aortic injury in the subacute phase and herein report the patient's clinical course...
November 29, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29177987/a-case-of-an-elderly-man-who-required-repeated-repair-of-a-ventricular-septal-defect-and-tricuspid-rupture-after-blunt-chest-trauma
#20
Shigefumi Matsuyama, Tomohiro Imazuru, Kaori Nakagawa, Tsukasa Ikeda, Tadanori Harada, Hiroo Ota, Naomi Ozawa, Mitsuru Iida, Tomoki Shimokawa
Several cases of traumatic ventricular septal defect (VSD) have been reported. However, traumatic VSD complicated by tricuspid rupture is rare. We report a case of traumatic VSD with tricuspid rupture who required repeated repair of both conditions. A 69-year-old man was transferred to our hospital for emergent surgical repair of traumatic VSD and tricuspid rupture. Although emergent repair was performed, a new left-to-right shunt and moderate tricuspid regurgitation appeared during his postoperative course...
November 25, 2017: General Thoracic and Cardiovascular Surgery
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