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https://www.readbyqxmd.com/read/28932697/thoracic-wall-trauma-misdiagnosed-lesions-on-radiographs-and-usefulness-of-ultrasound-multidetector-computed-tomography-and-magnetic-resonance-imaging
#1
REVIEW
Xavier Tomas, Catherine Facenda, Nuno Vaz, Edgar Augusto Castañeda, Montserrat Del Amo, Ana Isabel Garcia-Diez, Jaime Pomes
Blunt injuries to the chest wall are an important chapter on emergency room (ER) departments, being the third most common injuries in trauma patients which ominous complications could appear. This article describes different types of traumatic events affecting the chest wall, which maybe misdiagnosed with conventional X-ray. Special emphasis has been done in computed tomography (CT) and multidetector CT (MDCT) imaging. This technique is considered the "gold-standard" for those traumatic patients, due to its fast acquisition covering the whole area of interest in axial plane, reconstructing multiplanar (2D, 3D) volume-rendered images with a superb quality and angiographic CT capabilities for evaluating vascular damage...
August 2017: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28930941/thoracic-irrigation-prevents-retained-hemothorax-a-prospective-propensity-scored-analysis
#2
Nathan W Kugler, Thomas W Carver, David Milia, Jasmeet S Paul
BACKGROUND: Thoracic trauma resulting in hemothorax (HTx) is typically managed with thoracostomy tube (TT) placement; however, up to 20% of patients develop retained HTx which may necessitate further intervention for definitive management. While optimal management of retained HTx has been extensively researched, little is known about prevention of this complication. We hypothesized thoracic irrigation at the time of TT placement would significantly decrease the rate of retained HTx necessitating secondary intervention...
September 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28927984/limiting-thoracic-ct-a-rule-for-use-during-initial-pediatric-trauma-evaluation
#3
Caroline Q Stephens, Meredith C Boulos, Christopher R Connelly, Arvin Gee, Mubeen Jafri, Sanjay Krishnaswami
BACKGROUND: Despite increases in imaging guidelines for other body-regions during initial trauma assessment and the demonstrated utility of chest radiographs (CXR), guidelines for use of thoracic computed-tomography (TCT) are lacking. We hypothesized that TCT utilization had not decreased relative to other protocolized CTs, and mechanism and CXR could together predict significant injury independent of TCT. METHODS: We performed a retrospective review of blunt trauma patients ≤18 y...
September 4, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28917584/pneumatoceles-in-pediatric-blunt-trauma-common-and-benign
#4
Lindsey B Armstrong, David P Mooney
INTRODUCTION: Traumatic pneumatoceles are reported to be rare in children and to have an uncertain clinical significance. We report a single institution series of traumatic pneumatoceles to better define their frequency and clinical significance. METHODS: After obtaining approval from the IRB, data were extracted from the trauma registry of a level 1 pediatric trauma center on children diagnosed with a pulmonary contusion (International Classification of Diseases-9th edition diagnosis codes: 861...
August 7, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28912997/laparoscopic-repair-of-diaphragmatic-rupture-a-case-report-with-radiological-and-surgical-correlation
#5
Patrick Nguyen, Bonnie Davis, Daniel D Tran
The leading cause of diaphragmatic rupture is penetrating abdominal trauma, including gunshot- and stab-related wounds; however, diaphragmatic rupture can also result from blunt trauma to the abdomen. The diagnosis can be difficult to make as the physical examination may be unremarkable, and imaging, that is, a conventional chest X-ray and/or CT imaging, may initially fail to reveal the injury. Failure to recognize diaphragmatic rupture can result in a delayed presentation, sometimes years later, with a potential catastrophic outcome...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28894371/radiologic-findings-of-thoracic-trauma
#6
Cihan Akgul Ozmen, Serdar Onat, Delal Aycicek
INTRODUCTION: Chest trauma may be blunt or penetrating and the chest is the third most common trauma region. It is a significant cause of mortality. Multidetector computed tomography (MDCT) has been an increasingly used method to evaluate chest trauma because of its high success in detecting tissue and organ injuries. Herein, we aimed to present MDCT findings in patients with blunt and penetrating chest trauma admitted to our department. METHODS: A total of 240 patients admitted to the emergency department of our hospital between April 2012 and July 2013 with a diagnosis of chest trauma who underwent MDCT evaluations were included...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28878814/thoracic-trauma-severity-contributes-to-differences-in-intensive-care-therapy-and-mortality-of-severely-injured-patients-analysis-based-on-the-traumaregister-dgu%C3%A2
#7
Jörg Bayer, Rolf Lefering, Sylvia Reinhardt, Jan Kühle, Jörn Zwingmann, Norbert P Südkamp, Thorsten Hammer
BACKGROUND: Thoracic trauma is a relevant source of comorbidity throughout multiply-injured patient care. We aim to determine a measurable influence of chest trauma's severity on early resuscitation, intensive care therapy, and mortality in severely injured patients. METHODS: Patients documented between 2002 and 2012 in the TraumaRegister DGU®, aged ≥ 16 years, injury severity score (ISS) ≥ 16 are analyzed. Isolated brain injury and severe head injury led to exclusion...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28868230/sternal-fracture-in-children-diagnosis-by-ultrasonography
#8
Sergio B Sesia, Friederike Prüfer, Johannes Mayr
Because of its subcutaneous location, the sternum can be examined sonographically using a linear scanner. We report about two children who experienced blunt chest trauma. Anterior-posterior chest X-rays were normal. Ultrasonic imaging confirmed a fracture of the sternum with dorsal displacement of the distal fragment (by 0.97 cm) in the first child and a transverse fracture of the body of the sternum without displacement in the second child. In both children, pericardial effusion was excluded by sonography...
January 2017: European Journal of Pediatric Surgery Reports
https://www.readbyqxmd.com/read/28865527/emergency-computed-tomography-angiogram-of-the-chest-abdomen-and-pelvis
#9
Kimberly Weatherspoon, Wayne Gilbertie, Tara Catanzano
In the setting of blunt trauma, the rapid assessment of internal injuries is essential to prevent potentially fatal outcomes. Computed tomography is a useful diagnostic tool for both screening and diagnosis. In addition to trauma, acute chest syndromes often warrant emergent computed tomographic angiography, looking for etiologies such as aortic aneurysms or complications of aortic aneurysms, or both, pulmonary emboli, as well as other acute vascular process like aortic dissection and Takayasu aortitis. With continued improvements in diagnostic imaging, computed tomographic angiography of the chest, abdominal and pelvis proves to be an effective modality to image the aorta and other major vascular structures...
August 2017: Seminars in Ultrasound, CT, and MR
https://www.readbyqxmd.com/read/28865393/pediatric-aortoiliac-injury-following-blunt-abdominal-trauma-a-case-report
#10
Edward Daniele, Alan Coleman, Ben Hirsch, Thomas McGill, John Fitzwater
INTRODUCTION: The most common mechanism of aortic injury involves motor vehicle collisions resulting in aortic disruptions, occurring almost exclusively in the chest. Injury to the abdominal aorta following blunt trauma is nearly twenty times less likely to occur than the thoracic aorta. Because of the low incidence, there are few reports regarding the presentation and repair of these particular injuries, especially in the pediatric population. PRESENTATION OF CASE: We present a case of a 7-year-old boy involved in a high speed motor vehicle accident with an abdominal aorta transection at the aortic bifurcation extending into the left iliac artery...
July 20, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28855775/studying-morbidity-and-predicting-mortality-in-patients-with-blunt-chest-trauma-using-a-novel-clinical-score
#11
Priyadarshini Manay, Rajeev R Satoskar, V Karthik, Ram P Prajapati
BACKGROUND: A departmental audit in March 2015 revealed significant mortality rate of 40% in blunt chest trauma patients (much greater than the global 25%). A study was thus planned to study morbidity and predictors of mortality in blunt chest trauma patients admitted to our hospital. METHODS: This study was a prospective observational study of 139 patients with a history of blunt chest trauma between June 2015 and November 2015 after the Institutional Ethics Committee approval in April 2015...
July 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28852454/minimally-invasive-management-of-traumatic-lung-herniation
#12
Pablo Pérez Castro, Felipe Undurraga Machicao, Raimundo Santolaya Cohen, Raul Berrios Silva, Francisco Rivera
Post-traumatic pulmonary hernia can occur immediately after thoracic trauma or it may also appear months or even years after the onset. We report a case of a seventeen year-old male patient with thoracic blunt trauma secondary to high energy bicycle accident. Chest CT shows moderate hemothorax and pneumothorax, displaced fracture of the fifth left rib, and protusion of pulmonary tissue through a chest wall defect. In the Emergency Room the patient presents with chest pain (7/10 in Visual Analog Scale) and respiratory distress...
July 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28840745/delayed-diagnosis-of-bronchial-transection-following-blunt-chest-trauma
#13
Ali Reza Mohammadzadeh, Hamid Kayalha
Diagnosis of blunt tracheobronchial injuries can be challenging. These injuries may appear within months or years following the initial trauma. In general, diagnosis and treatment of delayed presentation of tracheobronchial injuries are uncommon. Herein, we present the case of a 48-year-old woman with complete transection of the right bronchus that was diagnosed 50 days after the initial trauma. Reconstructive surgery of the bronchus was performed successfully without any need for pulmonary resection.
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28801837/blunt-injuries-related-to-equestrian-sports-results-from-an-international-prospective-trauma-database-analysis
#14
Christian D Weber, Anthony R Nguyen, Rolf Lefering, Martijn Hofman, Frank Hildebrand, Hans-Christoph Pape
INTRODUCTION: The objective of this study was to investigate the nature, management, and outcome of major injuries related to equestrian sports and to define the at-risk groups for serious and life-threatening injuries. METHODS: We analyzed demographic, pre-hospital, clinical, and outcome data from an international population-based prospective trauma database (TraumaRegister DGU®). Patients with major injuries (Injury Severity Score [ISS] ≥9 points) related to equestrian sports activities were included (January 1, 1993, to December 31, 2012)...
August 11, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28801040/extracorporeal-cardiopulmonary-resuscitation-for-blunt-cardiac-rupture-a-case-report
#15
Shunsuke Kudo, Keiji Tanaka, Kunihiko Okada, Takahiro Takemura
Extracorporeal cardiopulmonary resuscitation (ECPR) followed by operating room sternotomy, rather than resuscitative thoracotomy, might be life-saving for patients with blunt cardiac rupture and cardiac arrest who do not have multiple severe traumatic injuries. A 49-year-old man was injured in a vehicle crash and transferred to the emergency department. On admission, he was hemodynamically stable, but a plain chest radiograph revealed a widened mediastinum, and echocardiography revealed hemopericardium. A computed tomography scan revealed hemopericardium and mediastinal hematoma, without other severe traumatic injuries...
August 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28797311/risk-factors-for-adverse-outcomes-in-older-adults-with-blunt-chest-trauma-a-systematic-review
#16
Jake Sawa, Robert S Green, Brent Thoma, Mete Erdogan, Philip J Davis
OBJECTIVES: The objective of this study was to systematically review the published literature for risk factors associated with adverse outcomes in older adults sustaining blunt chest trauma. METHODS: EMBASE and MEDLINE were searched from inception until March 2017 for prognostic factors associated with adverse outcomes in older adults sustaining blunt chest trauma using a pre-specified search strategy. References were independently screened for inclusion by two reviewers...
August 11, 2017: CJEM
https://www.readbyqxmd.com/read/28795026/rib-fractures-to-fix-or-not-to-fix-an-evidence-based-algorithm
#17
REVIEW
Michael Bemelman, M W de Kruijf, Mark van Baal, Luke Leenen
Rib fractures are a common injury resulting from blunt chest trauma. The most important complications associated with rib fractures include death, pneumonia, and the need for mechanical ventilation. The development of new osteosynthesis materials has stimulated increased interest in the surgical treatment of rib fractures. Surgical stabilisation, however, is not needed for every patient with rib fractures or for every patient with flail chest. This paper presents an easy-to-use evidence-based algorithm, developed by the authors, for the treatment of patients with flail chest and isolated rib fractures...
August 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28790100/missed-diaphragmatic-injury-after-blunt-trauma-presenting-with-colonic-strangulation-a-rare-scenario
#18
Atish Kumar, Dinesh Bagaria, Amulya Ratan, Amit Gupta
Diaphragmatic rupture occurs in 4%-5% cases of thoracoabdominal injuries. It may present acutely, in a delayed fashion or as a complicated hernia. We are describing the case of a young male presenting in respiratory distress with history of chest trauma 1.5 years back. On investigation, he was found to have left side diaphragmatic hernia containing gangrenous colon with lung collapse. The patient underwent successful operative intervention and discharged after 25 days of hospital stay. Record review suggested that the above mentioned diaphragm injury was missed in his evaluation 1...
August 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28764222/evaluation-of-myocardial-injury-using-standard-diagnostic-tools-and-tissue-doppler-imaging-in-blunt-trauma-chest
#19
Parshotam Lal Gautam, Neeru Luthra, Manpreet Kaur, Jaspal Singh, Gurpreet Singh Wander, Rohit Tandon, Namrata, Nikhil Gautam
INTRODUCTION: Myocardial contusion is an entity in chest trauma which is difficult to diagnose. Current practice relies more on cardiac-specific biochemical markers and standard echocardiography, but no gold standard test exists. The application of Tissue Doppler imaging is yet unexplored. AIM: The present study was designed to evaluate cardiac injury in patients with blunt trauma chest using conventional trans-thoracic echocardiography parameters and Tissue Doppler imaging...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28761404/left-internal-thoracic-artery-graft-to-left-anterior-descending-coronary-artery-after-blunt-chest-trauma-myocardial-infarction-14-year-outcome
#20
Paulo Roberto B Evora, Minna Moreira D Romano, Gabriela B Tannus de Souza, Danilo T Wada, André Schmidt, Alfredo José Rodrigues
In 2005, we reported an acute myocardial infarction secondary to a left anterior descending coronary artery injury sustained in a motorcycle accident. The treatment was late myocardial revascularization with in situ left internal thoracic artery-to-left anterior descending coronary artery anastomosis. There is little information available about the natural history of acute myocardial infarction after blunt chest trauma, especially when treated in this manner. This present communication reports the 14-year outcome in our patient...
June 2017: Texas Heart Institute Journal
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