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Abdominal Injury

Yidan Zhang, Wei Guo, Xiaodong Tang, Rongli Yang, Taiqiang Yan, Sen Dong, Shidong Wang, Nikolas Zaphiros
BACKGROUND: Although aortic balloon occlusion has been shown to reduce blood loss during sacral tumor resections, it has not been validated in larger sacral tumors involving the lower lumbar spine. If such an approach were shown to be associated with less blood loss, it might aid the tumor surgeon in resecting these difficult tumors. QUESTIONS/PURPOSES: (1) Is the use of aortic balloon occlusion associated with reduced blood loss in sacral tumor resections when the lower lumbar spine is also involved? (2) Does the use of the aortic balloon prolong total operating time? (3) What complications are associated with the use of a balloon? METHODS: We retrospectively studied all 56 patients diagnosed with sacral tumors involving the lower lumbar spine (L4, L5) who were treated surgically between 2004 and 2015 at our institute...
March 2018: Clinical Orthopaedics and related Research
William Bortcosh, Ashkon Shaahinfar, Sakina Sojar, Jean E Klig
PURPOSE OF REVIEW: The diagnostic capability, efficiency and versatility of point-of-care ultrasound (POCUS) have enabled its use in paediatric emergency medicine (PEM) and paediatric critical care (PICU). This review highlights the current applications of POCUS for the critically ill child across PEM and PICU to identify areas of progress and standardized practice and to elucidate areas for future research. RECENT FINDINGS: POCUS technology continues to evolve and advance bedside clinical care for critically ill children, with ongoing research extending its use for an array of clinical scenarios, including respiratory distress, trauma and dehydration...
March 9, 2018: Current Opinion in Pediatrics
Jeremy R Wortman, Jennifer W Uyeda, Urvi P Fulwadhva, Aaron D Sodickson
Computed tomography (CT) is key to the assessment of hemodynamically stable patients with blunt or penetrating trauma to the abdomen and pelvis. Dual-energy (DE) CT is a technology that allows acquisition of data at both high and low kilovolt peaks, allowing materials that have different x-ray absorption behaviors as a function of kilovolt peak (such as iodine) to be differentiated and quantified. DE CT has a variety of postprocessing applications that may be helpful in abdominal and pelvic trauma, including iodine-selective imaging, virtual monenergetic imaging, and virtual noncalcium imaging...
March 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Wesley Baas, Blake O'Connor, Ahmed El-Zawahry
A 57-year-old African American male presented with vague abdominal pain and bilateral flank pain. The patient was found to have bilateral hydronephrosis and significant renal function impairment secondary to pelvic lipomatosis. Pelvic lipomatosis represents a clinically-diagnosed unique cause of ureteral obstruction and subsequent renal impairment. We present a case report of newly diagnosed pelvic lipomatosis, the clinical and imaging characteristics for diagnosis, and its conservative management with serial ureteral stent exchanges...
February 2018: Canadian Journal of Urology
Yangyang R Yu, Annalyn S DeMello, Christopher S Greeley, Charles S Cox, Bindi J Naik-Mathuria, David E Wesson
PURPOSE: This study examines non-accidental trauma (NAT) fatalities as a percentage of all injury fatalities and identifies injury patterns in NAT admissions to two level 1 pediatric trauma centers. METHODS: We reviewed all children (<5years old) treated for NAT from 2011 to 2015. Patient demographics, injury sites, and survival were obtained from both institutional trauma registries. RESULTS: Of 4623 trauma admissions, 557 (12%) were due to NAT...
February 10, 2018: Journal of Pediatric Surgery
James M Bardes, Kenji Inaba, Morgan Schellenberg, Daniel Grabo, Aaron Strumwasser, Kazuhide Matsushima, Damon Clark, Niquelle Brown, Demetrios Demetriades
BACKGROUND: The distribution of trauma deaths was classically described as trimodal. With advances in both technology and trauma systems, this was re-evaluated and found to be bimodal in the early 2000s. Over the last decade there have been continued improvements in trauma and ICU care, related to damage control techniques and evidence based ICU pathways. A better understanding of the distribution of trauma deaths may be used to improve trauma systems. This study aimed to evaluate the contemporary distribution of trauma deaths after the widespread implementation of modern trauma and critical care principles...
March 8, 2018: Journal of Trauma and Acute Care Surgery
Galinos Barmparas, Deven C Patel, Nikhil T Linaval, Navpreet K Dhillon, Kavita A Patel, Daniel R Margulies, Eric J Ley
BACKGROUND: The presence of an abdominal seatbelt sign (ASBS) following a motor vehicle collision (MVC) is associated with a high risk for occult intraabdominal injury, prompting imaging studies and a prolonged period of clinical observation. The aim of this study was to determine how a negative computerized tomography (CT) of the abdomen/pelvis (A/P) can serve in the safe disposition of these patients. Our hypothesis was that in the setting of a negative CT, the presence of occult intra-abdominal injuries requiring a delayed intervention is extremely unlikely...
March 8, 2018: Journal of Trauma and Acute Care Surgery
Wanan Xiao, Xiaoxiao Yang, Yang Wang, Jianjun Li
BACKGROUND: Abdominal injuries combined with bone fractures are increasing. Splenectomies are often required, but have prolonged healing time for bone fracture. OBJECTIVES: The aim of the study was to explore the molecular mechanism for splenectomy delaying fracture healing. MATERIAL AND METHODS: Eighty-four patients (42 received splenectomy) who received hip fractures operations were recruited in our hospital. One-year follow-up analysis was performed...
February 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Calista M Harbaugh, Peng Zhang, Brianna Henderson, Brian A Derstine, Sven A Holcombe, Stewart C Wang, Carla Kohoyda-Inglis, Peter F Ehrlich
BACKGROUND: The "Cushion Effect," the phenomenon in which obesity protects against abdominal injury in adults in motor vehicle accidents, has not been evaluated among pediatric patients. This work evaluates the association between subcutaneous fat cross-sectional area, quantified using analytic morphomic techniques and abdominal injury. METHODS: This retrospective study includes 119 patients aged 1 to 18years involved in frontal impact motor vehicle accidents (2003-2015) with computed tomography scans...
February 10, 2018: Journal of Pediatric Surgery
Stephen A Harrison, Mary E Rinella, Manal F Abdelmalek, James F Trotter, Angelo H Paredes, Hays L Arnold, Marcelo Kugelmas, Mustafa R Bashir, Mark J Jaros, Lei Ling, Stephen J Rossi, Alex M DePaoli, Rohit Loomba
BACKGROUND: Non-alcoholic steatohepatitis is a chronic liver disease characterised by the presence of hepatic steatosis, inflammation, and hepatocellular injury, for which no Food and Drug Administration (FDA)-approved treatment exists. FGF19 is a hormone that regulates bile acid synthesis and glucose homoeostasis. We aimed to assess the safety and efficacy of NGM282, an engineered FGF19 analogue, for the treatment of non-alcoholic steatohepatitis. METHODS: In this randomised, double-blind, placebo-controlled, phase 2 study, we recruited patients aged 18-75 years with biopsy-confirmed non-alcoholic steatohepatitis as defined by the non-alcoholic steatohepatitis clinical research network histological scoring system, from hospitals and gastroenterology and liver clinics in Australia and the USA...
March 5, 2018: Lancet
Yexiang Sun, Chunyu Yuan, Xulin Chen, Fei Wang, Congsong Sun, Zhi Gao, Sheng Liu
OBJECTIVE: To investigate the effect of different concentrations of hypertonic saline solution (HS) on intestine injury in rats at the early stage of severe burn. METHODS: 104 adult healthy female Sprague-Dawley (SD) rats were randomly divided into five groups: sham group (n = 8), lactated Ringer solution (LR) group (n = 24) and 200, 300, 400 mmol/L HS group (HS200 group, HS300 group, HS400 group, all n = 24). All the rats in LR group and different concentrations of HS groups were scalded for 30% total body surface area (TBSA) with III degree, after immediately, the rats were given burn resuscitation therapy by LR or corresponding concentrations of HS through the tail vein...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Yanping Zhao, Bin Xie, Qiang Liu, Rongguang Luo, Yanna Wan, Karolina Malik, Efrem Civilini
Superior mesenteric arteriovenous fistulae (SMAVF) are extremely rare with no consensus about therapeutic indications and optimal approach. Here we present a case of a symptomatic SMAVF found in a young patient a few years after a penetrating abdominal injury. Following a complex clinical management of the acute status, we successfully managed the fistula with three covered stents in two consecutive endovascular procedures. Technical details of the performed procedures, including the main pitfalls and chosen solutions, have been explored and discussed...
March 5, 2018: Annals of Vascular Surgery
G Simonte, G Isernia, B Fiorucci, E Paciaroni, E Cieri, A Rebonato, M Lenti
During implantation of an Ovation endograft for abdominal aortic aneurysm correction a patient experienced anaphylactic reaction following polymer leakage outside the device circuit. Procedure was completed after hemodynamic stabilization. Since postoperative day ll, patient complained for loss of legs strength. Medullar injury was excluded by electromyography test and the clinical signs attributed to muscular necrosis and peripheral nerve involvement following arterial embolization. Furthermore, immediately after surgery, a wide erythematous area appeared in the lumbar region...
March 5, 2018: Annals of Vascular Surgery
Xue-Na Zheng, Jun Yang, Tao Xie, Bin Guo, Zhi-Qiang Xie, Li-Na Xie, Xue-Fen Wu, Gang-Zhu Hu, Mai-Lan Liu, Zeng-Hui Yue
OBJECTIVE: To observe the effect of herbal cake-separated moxibustion on blood lipid-apoprotein levels and the expression of Toll-like receptor 2 (TLR 2), TLR 4 and nuclear factor kappa B(NF-κB) mRNAs in atherosclerotic (AS) vulnerable plaques of hyperglycemia rabbits, so as to explore its mechanism underlying improvement of atherosclerosis. METHODS: Sixty New Zealand rabbits were randomly divided into 5 groups: control, model, direct moxibustion, herbal-cake-separated moxibustion and medication groups( n =12 rabbits in each group)...
February 25, 2018: Zhen Ci Yan Jiu, Acupuncture Research
Georgios Karaolanis, Dimitrios Moris, C Cameron McCoy, Diamantis I Tsilimigras, Sotirios Georgopoulos, Chris Bakoyiannis
The evaluation and management of patients with abdominal vascular trauma or injury requires immediate and effective decision-making in these unfavorable circumstances. The majority of these patients arrive at trauma centers in profound shock, secondary to massive blood loss, which is often unrelenting. Moreover, ischemia, compartment syndrome, thrombosis, and embolization may also be life threatening and require immediate intervention. To minimize the risk of these potentially lethal complications, early understanding of the disease process and emergent therapeutic intervention are necessary...
2018: Frontiers in Surgery
Thalita Bento Talizin, Meiry Sayuri Tsuda, Marcos Toshiyuki Tanita, Ivanil Aparecida Moro Kauss, Josiane Festti, Cláudia Maria Dantas de Maio Carrilho, Cintia Magalhães Carvalho Grion, Lucienne Tibery Queiroz Cardoso
OBJECTIVE: To evaluate the frequency of intra-abdominal hypertension in major burn patients and its association with the occurrence of acute kidney injury. METHODS: This was a prospective cohort study of a population of burn patients hospitalized in a specialized intensive care unit. A convenience sample was taken of adult patients hospitalized in the period from 1 August 2015 to 31 October 2016. Clinical and burn data were collected, and serial intra-abdominal pressure measurements taken...
March 1, 2018: Revista Brasileira de Terapia Intensiva
Si-Dong Wei, Ding Cao, Xue-Song Xu, He Bai, Hao Wu, Meng-Hao Wang
The present study investigated the effects of matrix metalloproteinases (MMPs) and tissue inhibitor of metalloproteinases (TIMPs) in transplantation-associated arteriosclerosis by observing their expression in transplanted aortas in rats. Allogenic and isogenic abdominal aortic transplantations were performed and grafts were removed from the recipients at the designated time points (day 7, 14, 28 and 56 post transplantation). Hematoxylin and eosin staining, immunohistochemistry, immunofluorescence and western blot analysis were used to evaluate the grafts...
March 6, 2018: Molecular Medicine Reports
Abdullah Alfawaz, Jun Tashiro, Danny Sleeman, Keith Jones, Jorge Rey
Aorto-enteric fistulae pose a challenging negative outcome of aortic intervention. Treatment involves graft excision, and recently, more enthusiasm has met in situ revascularization over extra-anatomic bypass. This has been traditionally performed through the transperitoneal approach via a midline abdominal incision. We propose an exclusively total retroperitoneal technique in managing this complication with regard to both the vascular and alimentary tract technical aspects of the procedure. This involves exclusion and bypass of the affected segment followed by en-mass resection of the affected segment with the duodenum, and finally, bowel anastomosis...
2018: SAGE Open Medical Case Reports
Ingmar L Defize, Bernadette Schurink, Teus J Weijs, Tom A P Roeling, Jelle P Ruurda, Richard van Hillegersberg, Ronald L A W Bleys
BACKGROUND: Injury and subsequent leakage of unrecognized thoracic duct tributaries during transthoracic esophagectomy may lead to chylothorax. Therefore, we hypothesized that thoracic duct anatomy at the diaphragm is more complex than currently recognized and aimed to provide a detailed description of the anatomy of the thoracic duct at the diaphragm. BASIC PROCEDURES: The thoracic duct and its tributaries were dissected in 7 (2 male and 5 female) embalmed human cadavers...
March 3, 2018: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
Kenji Sakai, Tomohiro Mizuno, Taiju Watanabe, Eiki Nagaoka, Keiji Oi, Masafumi Yashima, Tsuyoshi Hachimaru, Hidehito Kuroki, Tatsuki Fujiwara, Masashi Takeshita, Minoru Tanabe, Hirokuni Arai
BACKGROUND: The right gastroepiploic artery (GEA) is utilized as an excellent in-situ arterial graft conduit to right coronary artery territory for coronary artery bypass grafting (CABG). However, there remains great concerns regarding the management of patients with a patent in-situ GEA during abdominal surgery following CABG. METHODS: From 1995 to 2016, GEA was used for CABG in 278 patients at our institution. Of the patients, 14 abdominal surgeries were performed for subsequent abdominal diseases in 11 patients with a patent in-situ GEA for CABG...
March 3, 2018: Annals of Thoracic Surgery
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