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Pediatric abdominal trauma

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https://www.readbyqxmd.com/read/28431416/caring-for-critically-injured-children-an-analysis-of-56-pediatric-damage-control-laparotomies
#1
Miguel A Villalobos, Joshua P Hazelton, Rachel L Choron, Lisa Capano-Wehrle, Krystal Hunter, John P Gaughan, Steven E Ross, Mark J Seamon
BACKGROUND: Injury is the leading cause of death in children under 18 years. Damage control principles have been extensively studied in adults but remain relatively unstudied in children. Our primary study objective was to evaluate the use of damage control laparotomy (DCL) in critically injured children. METHODS: An American College of Surgeons-verified Level 1 trauma center review (1996-2013) of pediatric trauma laparotomies was undertaken. Exclusion criteria included: age older than 18 years, laparotomy for abdominal compartment syndrome or delayed longer than 2 hours after admission...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28423091/an-unusual-abdominal-wall-mass-in-a-child
#2
Amalia Maria do Espirito Santo Souza, Tomas Marzagão Barbuto, Flávia Alessandra Freitas, Nathalia Fernandes Vianna, Carla Maria Costa Zanchetta, Silvana Forsait, Claudio Borba, Alessandra Milani Prandini de Azambuja, Lilian Maria Cristofani, Vicente Odone
Abdominal tumors are one of the most common types of pediatric cancer. Therefore, they should always be included in the differential diagnosis of abdominal masses. Here, we present the case of a child whose initial hypothesis of diagnosis contemplated this possibility. Later, it was demonstrated that the abdominal mass found was secondary to a common parasitosis. A 2-year old, moderately malnourished and pale white boy was referred with a history of a rapidly growing, well-limited, middle abdominal mass. The mass was 10 by 3 cm, hard and poorly movable, apparently involving both abdominal rectus muscles...
April 13, 2017: Revista do Instituto de Medicina Tropical de São Paulo
https://www.readbyqxmd.com/read/28406853/the-role-of-computed-tomography-in-the-classification-of-pediatric-pelvic-fractures-revisited
#3
Bent Ma, Hennrikus Wl, Latorre Je, Armstrong Dg, Shaw B, Jones Kc, Segal Ls
OBJECTIVES: To determine the need of CT scans in the assessment of pediatric pelvic fractures DESIGN:: Retrospective Chart Review SETTING:: Level-1 Pediatric Trauma CenterPatients/Participants: 30 pediatric trauma patients with pelvic fractures who have obtained both a radiograph and CT Scan MAIN OUTCOME MEASUREMENTS:: Fleiss Kappa coefficient to compare inter-reliability. RESULTS: The average age of the patients was 7 years (range 1-13 years). 17 were male and 13 were female...
April 10, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28398961/accreditation-council-for-graduate-medical-education-acgme-surgery-resident-operative-logs-the-last-quarter-century
#4
Frederick Thurston Drake, Shahram Aarabi, Brandon T Garland, Ciara R Huntington, Jarod P McAteer, Morgan K Richards, Nicole Kansier Zern, Kenneth W Gow
STUDY OBJECTIVE: To describe secular trends in operative experience for surgical trainees across an extended period using the most comprehensive data available, the Accreditation Council for Graduate Medical Education (ACGME) case logs. BACKGROUND: Some experts have expressed concern that current trainees are inadequately prepared for independent practice. One frequently mentioned factor is whether duty hours' restrictions (DHR) implemented in 2003 and 2004 contributed by reducing time spent in the operating room...
May 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28376073/point-of-care-ultrasound-diagnosis-of-traumatic-abdominal-wall-hernia
#5
Lori B Bjork, Shawna D Bellew, Tobias Kummer
Traumatic abdominal wall hernias due to blunt abdominal trauma in pediatric patients can pose a diagnostic challenge because of spontaneous hernia reduction. Ultrasonography may be superior to computed tomography for this indication in some cases because of the ability to dynamically and repeatedly assess the area of injury. Herniation can be induced or exaggerated via Valsalva maneuvers, which can facilitate its detection during dynamic assessment. We present the case of a 3-year-old boy who sustained blunt abdominal trauma, with a resultant abdominal wall hernia that was diagnosed using point-of-care ultrasound imaging...
April 4, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28351519/contrast-enhanced-ultrasound-for-the-evaluation-of-blunt-pediatric-abdominal-trauma
#6
Lindsey B Armstrong, David P Mooney, Harriet Paltiel, Carol Barnewolt, Beatrice Dionigi, Mary Arbuthnot, Chinwendu Onwubiko, Susan A Connolly, Delma Y Jarrett, Jill M Zalieckas
INTRODUCTION: Blunt abdominal trauma is a common problem in children. Computed tomography (CT) is the gold standard for imaging in pediatric blunt abdominal trauma, however up to 50% of CTs are normal and CT carries a risk of radiation-induced cancer. Contrast enhanced ultrasound (CEUS) may allow accurate detection of abdominal organ injuries while eliminating exposure to ionizing radiation. METHODS: Children aged 7-18years with a CT-diagnosed abdominal solid organ injury underwent grayscale/power Doppler ultrasound (conventional US) and CEUS within 48h of injury...
March 20, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28338594/the-association-of-non-accidental-trauma-with-historical-factors-exam-findings-and-diagnostic-testing-during-the-initial-trauma-evaluation
#7
Mauricio A Escobar, Marc Auerbach, Katherine Flynn-O'Brien, Gunjan Tiyyagura, Matthew A Borgman, Susan J Duffy, Kelly Falcone, Rita Burke, John M Cox, Sabine Maguire
Early identification of non-accidental trauma (NAT) is a critical component of pediatric trauma care. Literature searches were conducted related to the association of NAT with seven key areas: history, exam findings (burns, oral trauma, bruising) and imaging (fractures, abdominal and brain injuries). When available, odds ratios (OR) with 95% confidence intervals (CI) for associations with NAT are presented. Systematic reviews have been published in six of the seven key areas and are described. The operational definition of NAT was widely variable across studies, prohibiting meta-analysis...
March 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28325786/impact-on-hospital-resources-of-systematic-evaluation-and-management-of-suspected-nonaccidental-trauma-in-patients-less-than-4-years-of-age
#8
Bethann M Pflugeisen, Mauricio A Escobar, Dustin Haferbecker, Yolanda Duralde, Elizabeth Pohlson
OBJECTIVE: There has been an increasing movement worldwide to create systematic screening and management procedures for atypical injury patterns in children with the hope of better detecting and evaluating nonaccidental trauma (NAT). A legitimate concern for any hospital considering implementation of a systematic evaluation process is the impact on already burdened hospital resources. We hypothesized that implementation of a guideline that uses red flags related to history, physical, or radiologic findings to trigger a standardized NAT evaluation of patients <4 years would not negatively affect resource utilization at our level II pediatric trauma center...
March 21, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28302282/traumatic-pelvic-fractures-in-children-and-adolescents
#9
Christopher J DeFrancesco, Wudbhav N Sankar
Although traumatic pelvic fractures in children are relatively rare, these injuries are identified in about 5% of children admitted to level 1 trauma centers after blunt trauma.(1-4) Such injuries differ from adult pelvic fractures in important ways and require distinct strategies for management. While the associated mortality rate for children with pelvic fractures is much lower than that for adults, the patient may require urgent surgical intervention for associated life-threatening injuries such as head trauma and abdominal injury...
February 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28255580/clinical-applications-of-contrast-enhanced-ultrasound-in-the-pediatric-work-up-of-focal-liver-lesions-and-blunt-abdominal-trauma-a-systematic-review
#10
REVIEW
Nicolaj Grønbæk Laugesen, Christian Pallson Nolsoe, Jacob Rosenberg
In pediatrics ultrasound has long been viewed more favorably than imaging that exposes patients to radiation and iodinated contrast or requires sedation. It is child-friendly and diagnostic capabilities have been improved with the advent of contrast-enhanced ultrasound (CEUS). The application of CEUS is indeed promising. However, no ultrasound contrast agent manufactured today is registered for pediatric use in Europe. The contrast agent SonoVue(®) has recently been approved by the FDA under the name of Lumason(®) to be used in hepatic investigations in adults and children...
February 2017: Ultrasound International Open
https://www.readbyqxmd.com/read/28239409/iroa-international-register-of-open-abdomen-preliminary-results
#11
Federico Coccolini, Giulia Montori, Marco Ceresoli, Fausto Catena, Rao Ivatury, Michael Sugrue, Massimo Sartelli, Paola Fugazzola, Davide Corbella, Francesco Salvetti, Ionut Negoi, Monica Zese, Savino Occhionorelli, Stefano Maccatrozzo, Sergei Shlyapnikov, Christian Galatioto, Massimo Chiarugi, Zaza Demetrashvili, Daniele Dondossola, Yovcho Yovtchev, Orestis Ioannidis, Giuseppe Novelli, Mirco Nacoti, Desmond Khor, Kenji Inaba, Demetrios Demetriades, Torsten Kaussen, Asri Che Jusoh, Wagih Ghannam, Boris Sakakushev, Ohad Guetta, Agron Dogjani, Stefano Costa, Sandeep Singh, Dimitrios Damaskos, Arda Isik, Kuo-Ching Yuan, Francesco Trotta, Stefano Rausei, Aleix Martinez-Perez, Giovanni Bellanova, Vinicius Cordeiro Fonseca, Fernando Hernández, Athanasios Marinis, Wellington Fernandes, Martha Quiodettis, Miklosh Bala, Andras Vereczkei, Rafael L Curado, Gustavo Pereira Fraga, Bruno M Pereira, Mahir Gachabayov, Guillermo Perez Chagerben, Miguel Leon Arellano, Sefa Ozyazici, Gianluca Costa, Tugan Tezcaner, Luca Ansaloni
BACKGROUND: No definitive data about open abdomen (OA) epidemiology and outcomes exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) promoted the International Register of Open Abdomen (IROA). METHODS: A prospective observational cohort study including patients with an OA treatment. Data were recorded on a web platform (Clinical Registers®) through a dedicated website: www.clinicalregisters.org. RESULTS: Four hundred two patients enrolled...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28209449/maxillofacial-and-concomitant-serious-injuries-an-eight-year-single-center-experience
#12
Fausto Fama, Marco Cicciu, Alessandro Sindoni, Enrico Nastro-Siniscalchi, Roberto Falzea, Gabriele Cervino, Francesca Polito, Francesco De Ponte, Maria Gioffre-Florio
PURPOSE: Maxillofacial injuries are frequently associated with multiple trauma and can determine functional and aesthetic bad outcomes. The severity of maxillofacial injuries may be considerable and can divert clinicians' attention from other concomitant injuries which is less evident but potentially life-threatening. The aim of this study was to find out the concomitant injuries in patients referred to the Emergency Department (ED) of the University Hospital of Messina (North-East Sicily, Italy) for maxillofacial traumas...
February 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28188036/outcomes-of-an-accelerated-care-pathway-for-pediatric-blunt-solid-organ-injuries-in-a-public-healthcare-system
#13
Oluwatomilayo Daodu, Mary Brindle, Carlos R Alvarez-Allende, Lisette Lockyer, Bryce Weber, Steven R Lopushinsky
PURPOSE: An accelerated clinical care pathway for solid organ abdominal injuries was implemented at a level one pediatric trauma center. The impact on resource utilization and demonstration of protocol safety was assessed. METHODS: Data were collected retrospectively on patients admitted with blunt abdominal solid organ injuries from 2012 to 2015. Patients were subdivided into pre- and post-protocol groups. Length of hospital stay (LOS) and failure of non-operative treatment were the primary outcomes of interest...
January 29, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28186860/traumatic-rib-injury-patterns-imaging-pitfalls-complications-and-treatment
#14
Brett S Talbot, Christopher P Gange, Apeksha Chaturvedi, Nina Klionsky, Susan K Hobbs, Abhishek Chaturvedi
The ribs are frequently affected by blunt or penetrating injury to the thorax. In the emergency department setting, it is vital for the interpreting radiologist to not only identify the presence of rib injuries but also alert the clinician about organ-specific injury, specific traumatic patterns, and acute rib trauma complications that require emergent attention. Rib injuries can be separated into specific morphologic fracture patterns that include stress, buckle, nondisplaced, displaced, segmental, and pathologic fractures...
March 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28168326/damage-control-laparotomy-for-abdominal-trauma-in-children
#15
Stephanie F Polites, Elizabeth B Habermann, Amy E Glasgow, Martin D Zielinski
BACKGROUND: Damage control laparotomy (DCL) is not well studied in the pediatric trauma population. The purpose of this study was to develop a surrogate definition of DCL compatible with national and administrative data sources so that the rate and outcomes of DCL in pediatric trauma patients could be determined. METHODS: Using the 2010-2014 National Trauma Data Bank, children ≤18 with an abdominal AIS ≥ 3 who underwent a laparotomy within 3 h of arrival were identified (n = 2989)...
February 6, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28139109/-distal-pancreatectomy-with-splenic-preservation-in-pediatric-patient-with-blunt-abdominal-trauma
#16
J T Palacios-Zertuche, J G Martínez-Flores, Q Gilte-Limas, M A Pinzón-Uresti, F J Reyna-Sepúlveda, G E Muñoz-Maldonado
INTRODUCTION: Traumatic injuries of the pancreas occur in 3 to 12% of cases of blunt abdominal trauma in children and these are associated with a mortality of 30%. CASE REPORT: A four-year-old girl was brought to the emergency room after an automobile accident. On physical examination, she was stable with abdominal pain and signs of peritoneal irritation. An abdominal CT scan showed a grade II liver lesion, a grade II splenic lesion, and a grade III pancreatic lesion...
April 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28130170/identifying-children-at-very-low-risk-for-blunt-intra-abdominal-injury-in-whom-ct-of-the-abdomen-can-be-avoided-safely
#17
Christian J Streck, Adam M Vogel, Jingwen Zhang, Eunice Y Huang, Matthew T Santore, Kuojen Tsao, Richard A Falcone, Melvin S Dassinger, Robert T Russell, Martin L Blakely
BACKGROUND: Computed tomography is commonly used to rule out intra-abdominal injury (IAI) in children, despite associated cost and radiation exposure. Our purpose was to derive a prediction rule to identify children at very low risk for IAI after blunt abdominal trauma (BAT) for whom a CT scan of the abdomen would be unnecessary. STUDY DESIGN: We prospectively enrolled children younger than 16 years of age who presented after BAT at 14 Level I pediatric trauma centers during 1 year...
January 24, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28017711/evaluation-of-the-hypothesis-that-choking-alte-may-mimic-abusive-head-trauma
#18
Jennifer B Hansen, Terra Frazier, Mary Moffatt, Timothy Zinkus, James D Anderst
OBJECTIVE: Apparent life-threatening events (ALTEs), often accompanied by choking, have been hypothesized to cause subdural hemorrhages (SDH), retinal hemorrhages, and brain injury. If the choking/ALTE hypothesis were true, children who present with ALTE and SDH would have fewer extracranial injuries suspicious for abuse than those with SDH and no ALTE. We aimed to compare the prevalence of suspicious extracranial injuries in children who have ALTE-associated SDH to those with non-ALTE SDH...
December 22, 2016: Academic Pediatrics
https://www.readbyqxmd.com/read/27998635/predictors-of-intrathoracic-injury-after-blunt-torso-trauma-in-children-presenting-to-an-emergency-department-as-trauma-activations
#19
Caitlin McNamara, Irina Mironova, Erik Lehman, Robert P Olympia
BACKGROUND: Thoracic injuries are a major cause of death associated with blunt trauma in children. Screening for injury with chest x-ray study, compared with chest computed tomography (CT) scan, has been controversial, weighing the benefits of specificity with the detriment of radiation exposure. OBJECTIVE: To identify predictors of thoracic injury in children presenting as trauma activations to a Level I trauma center after blunt torso trauma, and to compare these predictors with those previously reported in the literature...
December 17, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27992751/blunt-abdominal-trauma-from-motor-vehicle-collisions-from-2007-to-2011-renal-injury-probability-and-severity-in-children-versus-adults
#20
Michael P Kurtz, Jairam R Eswara, Joel M Vetter, Caleb P Nelson, Steven B Brandes
PURPOSE: There are sparse data directly comparing the probability of renal injury in children and adults. The kidney of the child is believed to be more susceptible to blunt injury for a variety of anatomical reasons. In a large cohort we tested the hypothesis that the pediatric kidney is more susceptible to any renal injury and to higher grade injury. MATERIALS AND METHODS: We queried the NTDB® (National Trauma Data Bank®) on all hospital admissions following motor vehicle collisions in a pediatric population (age less than 21 years) and a referent adult population (age 30 to 50 years)...
March 2017: Journal of Urology
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