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Pediatric abdominal trauma

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https://www.readbyqxmd.com/read/27912976/implications-of-a-negative-abdominal-ct-in-the-management-of-pediatric-blunt-abdominal-trauma
#1
Sarah Braungart, Thomas Beattie, Paula Midgley, Mark Powis
BACKGROUND: No consensus exists on management of children with a negative trauma CT following blunt abdominal trauma (BAT). Asymptomatic children are frequently "admitted for observation" following negative CT owing to concerns about missing an intraabdominal injury (IAI) without evidence for this practice. We aimed to investigate the feasibility of discharge following a negative CT scan in children sustaining blunt abdominal trauma. METHODS: Retrospective audit at a UK paediatric major trauma center and review of the literature...
November 14, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27908962/pediatric-traumatic-gallbladder-rupture
#2
W Landon Jackson, Patrick C Bonasso, R Todd Maxson
Blunt abdominal trauma causing gallbladder rupture is exceptionally rare in children. This injury is rare due to the size and anatomical location of the gallbladder, and a rapid diagnosis is often difficult to achieve due to delayed presentation. We report a ruptured gallbladder in an 11-year-old male as a result of blunt abdominal trauma from an all-terrain vehicle accident. Possible gallbladder injury was indicated on computed tomography and patient was successfully managed with cholecystectomy.
December 1, 2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/27902668/pneumatosis-intestinalis-due-to-child-abuse
#3
Stephanie Anne Deutsch, Cindy W Christian
Pneumatosis intestinalis (PI) and the presence of portal venous gas (PVG) are commonly considered pathognomonic for necrotizing enterocolitis in the neonatal period; however, these 2 radiographic findings have been documented in all age groups in a variety of clinical settings and medical conditions including respiratory, cardiac, rheumatologic, gastrointestinal disorders, and traumatic injury. In children, intramural dissection of intestinal gas in the absence of clinical symptoms suggestive of necrotizing enterocolitis should raise concern for a traumatic etiology, including injuries sustained from child physical abuse...
November 29, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27894432/abdominal-trauma-evaluation-for-the-pediatric-surgeon
#4
REVIEW
Sabrina Drexel, Kenneth Azarow, Mubeen A Jafri
Trauma is the leading cause of pediatric mortality and abdominal injury is a significant contributor to morbidity. The assessment of abdominal trauma in children must be conducted expeditiously and thoroughly. Physical examination, laboratory testing, and imaging are central to trauma evaluation. In children with minor injury, protocols may help to limit the use of ionizing radiation. Children with significant abdominal injury who are unstable should be resuscitated with blood products and undergo emergent surgical intervention...
February 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/27878593/re-evaluation-of-liver-transaminase-cutoff-for-ct-after-pediatric-blunt-abdominal-trauma
#5
Jessica A Zagory, Avafia Dossa, Jamie Golden, Aaron R Jensen, Catherine J Goodhue, Jeffrey S Upperman, Christopher P Gayer
PURPOSE: Current guidelines for computed tomography (CT) after blunt trauma were developed to capture all intra-abdominal injuries (IAI). We hypothesize that current AST/ALT guidelines are too low leading to unnecessary CT scans for children after blunt abdominal trauma (BAT). METHODS: Patients who received CT of the abdomen after blunt trauma at our Level I Pediatric Trauma Center were stratified into a high risk (HR) (liver/spleen/kidney grade ≥III, hollow viscous, or pancreatic injuries) and low risk (LR) (liver/kidney/spleen injuries grade ≤II, or no IAI) groups...
November 23, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27851192/1557-characteristics-and-predictors-of-intensive-care-unit-admission-in-pediatric-blunt-abdominal-trauma
#6
Adam Vogel, Robert Russell, Melvin Dassinger, Martin Blakely, Matthew Santore, Kuojen Tsao, Eunice Huang, Christian Streck
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27817834/a-comparison-study-of-pelvic-fractures-and-associated-abdominal-injuries-between-pediatric-and-adult-blunt-trauma-patients
#7
Forat Swaid, Kobi Peleg, Ricardo Alfici, Oded Olsha, Adi Givon, Boris Kessel
PURPOSE: Pelvic fractures are a marker of severe injury, mandating a thorough investigation for the presence of associated injuries. Anatomical and physiological differences between adults and children may lead to a different impact of pelvic fractures on these populations. The purpose of this study is to compare pelvic fractures between pediatric and adult blunt trauma victims, mainly regarding their severity and associated intraabdominal injuries. METHODS: A retrospective study involving blunt trauma patients suffering pelvic fractures, according to the records of the Israeli National Trauma Registry...
September 23, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27815994/traumatic-jejunal-hematoma-in-childhood-a-case-report-and-review-of-literature
#8
Noura Al-Zarouni, Labib Al-Ozaibi, Ali Khammas, Nusaiba Al-Suwaidi, Alya Al-Mazroui, Faisal Al-Badri
INTRODUCTION: Intramural jejunal hematoma is a very rare condition with only few cases reported in the literature. It rarely occurs spontaneously, and is mostly seen in hemophiliac patients and is also associated with abdominal trauma. It occurs more commonly in children than in adults and can present with features of intestinal obstruction. CASE PRESENTATION: A 10year old boy presented with features of intestinal obstruction. He sustained a blunt abdominal trauma two days prior to presentation...
October 27, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27813386/retroperitoneoscopic-pyelolithotomy-a-good-alternative-treatment-for-renal-pelvic-calculi-in-children
#9
Bruno Nicolino Cezarino, Rubens Park, Paulo Renato Marcelo Moscardi, Roberto Iglesias Lopes, Francisco T Denes, Miguel Srougi
INTRODUCTION: Nephrolitiasis, once considered an adult disease, has become increasingly prevalent in children, with na increase from 6% to 10 % annually in past 25 years. Kidney stones in pediatric population can result from metabolic diseases in up to 50% of children affected. Other factors associated with litiasis are infection, dietary factors, and anatomic malformations of urinary tract. Standard treatment procedures for pediatric population are similar to adult population. Extracorporeal shock wave lithotripsy (ESWL), ureterorenoscopy (URS), percutaneous nepfrolithotomy (PCNL), as well as laparoscopic and retroperitoneoscopic approaches can be indicated in selected cases...
November 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/27806534/association-between-adrenal-hematoma-and-mortality-in-pediatric-multiple-blunt-traumas-an-autopsy-evaluation
#10
Farrokh Taftachi, Leyla Abdolkarimi, Maryam Ameri, Azadeh Memarian, Alireza Behzadi, Hooman Bakhshandeh
Adrenal hematoma is a common hidden catastrophic complication in pediatric victims of multiple blunt traumas. Adrenal hematoma has no obvious symptoms and may not be detected by diagnostic methods such as magnetic resonance imaging, computed tomography scan, and sonography; consequently, this complication may be neglected in children with multiple blunt traumas and cause death through sudden adrenal crisis.The current study was conducted on 55 dead children (<13 y) and 110 matured youths (13-17 y) who died in consequence of multiple blunt traumas, comprising car crashes, fall from heights, and falling debris...
August 4, 2016: Global Journal of Health Science
https://www.readbyqxmd.com/read/27770153/traumatic-diaphragmatic-rupture-in-pediatric-age-review-of-the-literature
#11
F Marzona, N Parri, A Nocerino, M Giacalone, E Valentini, S Masi, L Bussolin
PURPOSE: Traumatic diaphragm rupture (TDR) is a rare complication of trauma in pediatric age and may be easily missed by the severity of associated injuries so that delayed emergent presentation can occur with increased rate of morbidity and mortality. No review has been available to guide clinicians through the pitfalls and the initial diagnostic approach to pediatric TDR. METHODS: A Medline thorough search on TDR was conducted using different queries. English language citations were identified during the period of January 2000 through December 2014 limiting the search to pediatric age (0-18 years)...
October 21, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27731956/the-effect-of-ultrasound-guided-transversus-abdominis-plane-tap-block-on-postoperative-analgesia-and-neuroendocrine-stress-response-in-pediatric-patients-undergoing-elective-open-inguinal-hernia-repair
#12
Mohamed M Abu Elyazed, Shaimaa F Mostafa, Mohammad A Abdullah, Gehan M Eid
BACKGROUND: Transversus abdominis plane block (TAP) is a compartmental block of the anterior abdominal wall. Surgical trauma produces multisystem reactions. Anesthetic techniques can modify the neuroendocrine surgical stress response. AIM: The aim of this study was to evaluate the effect of TAP block on the modification of the surgical neuroendocrine stress response as well as its analgesia effect in children undergoing open inguinal hernia repair. METHOD: Sixty children aged 3-10 years undergoing elective unilateral open inguinal hernia repair were randomized into group I (general anesthesia) or group II (received TAP block after induction of general anesthesia)...
December 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27707653/the-impact-of-morbid-obesity-on-solid-organ-injury-in-children-using-the-atomac-protocol-at-a-pediatric-level-i-trauma-center
#13
Nathan Vaughan, Jeff Tweed, Cynthia Greenwell, David M Notrica, Crystal S Langlais, Shawn D St Peter, Charles M Leys, Daniel J Ostlie, R Todd Maxson, Todd Ponsky, David W Tuggle, James W Eubanks, Amina Bhatia, Cynthia Greenwell, Nilda M Garcia, Karla A Lawson, Prasenjeet Motghare, Robert W Letton, Adam C Alder
INTRODUCTION: Obesity is an epidemic in the pediatric population. Childhood obesity in trauma has been associated with increased incidence of long-bone fractures, longer ICU stays, and decreased closed head injuries. We investigated for differences in the likelihood of failure of non-operative management (NOM), and injury grade using a subset of a multi-institutional, prospective database of pediatric patients with solid organ injury (SOI). METHODS: We prospectively collected data on all pediatric patients (<18years) admitted for liver or splenic injury from September 2013 to January 2016...
September 13, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27682469/predictors-of-mortality-in-pediatric-urban-firearm-injuries
#14
Kelly A Feldman, Jun Tashiro, Casey J Allen, Eduardo A Perez, Holly L Neville, Carl I Schulman, Juan E Sola
BACKGROUND: Although firearms account for less than 5 % of all pediatric injuries, they have the highest associated case fatality rate. METHODS: The registry at a Level-1 trauma center was used to identify firearm injuries (<18 years of age) from 1991 to 2011. Descriptive statistics and risk-adjusted multivariate analyses (MVA) were performed. RESULTS: Overall, 1085 patients were identified. Immediate operations were performed in 33 % (n = 358) of patients with most having abdominal surgery (n = 214)...
September 28, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27668913/interventricular-septal-pseudoaneurysm-after-blunt-chest-trauma-in-a-6-year-old-an-illustrative-case-and-review
#15
Natalie Behrle, Peter Dyke, Abdallah Dalabih
Motor vehicle accident is the most common cause of blunt cardiac injury (BCI) in children (85.3%) due to the height of the child in relation to proper restraints and the compliant pediatric rib cage (J Trauma. 1996;40:200-202). Trauma to the chest wall may lead to injury of the myocardium, resulting in myocardial contusion, ventricular septal defect (VSD), ventricular free wall rupture, or valve compromise (J Trauma. 1996;40; 200-202; Heart Lung. 2012;41:200-202; J Inj Violence Res. 2012;4:98-100). There are several proposed mechanisms for the formation of VSD after blunt chest trauma including rupture of ischemic myocardium related to the initial trauma and reopening of a spontaneously closed congenital VSD...
September 23, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27598611/-minimally-invasive-theurapeutic-approaches-in-pediatric-nonvascular-fourth-grade-renal-trauma
#16
Ayşe Başak Uçan, Zehra Günyüz Temir, Arzu Şencan, Aytaç Karkıner, Hüseyin Evciler
BACKGROUND: Conservative management procedures are implemented in cases of low-grade pediatric blunt renal trauma, but procedures for grade 4 injuries are not clearly defined. The present objective was to discuss treatment procedures in patients who presented with or developed urinoma during follow-up. METHODS: Treatment procedures implemented in 8 patients (female:male ratio=1:7; average age: 6) with grade 4 renal trauma who presented to the clinic between 2003 and 2012 were retrospectively analyzed...
July 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/27577183/management-of-blunt-pancreatic-trauma-in-children-review-of-the-national-trauma-data-bank
#17
Brian R Englum, Brian C Gulack, Henry E Rice, John E Scarborough, Obinna O Adibe
PURPOSE: This study aims to examine the current management strategies and outcomes after blunt pancreatic trauma in children using a national patient registry. METHODS: Using the National Trauma Data Bank (NTDB) from 2007-2011, we identified all patients ≤18years old who suffered blunt pancreatic trauma. Patients were categorized as undergoing nonoperative pancreatic management (no abdominal operation, abdominal operation without pancreatic-specific procedure, or pancreatic drainage alone) or operative pancreatic management (pancreatic resection/repair)...
September 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27561373/posttraumatic-levels-of-liver-enzymes-can-reduce-the-need-for-ct-in-children-a-retrospective-cohort-study
#18
Peter James Bruhn, Lene Østerballe, Jens Hillingsø, Lars Bo Svendsen, Frederik Helgstrand
BACKGROUND: Computed tomography (CT) is the gold standard in the initial evaluation of the hemodynamically stable patient with suspected liver trauma. However, the adverse effects of radiation exposure are of specific concern in the pediatric population. It is therefore desirable to explore alternative diagnostic modalities. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are hepatic enzymes, which are elevated in peripheral blood in relation to liver injury. The aim of the present study was to investigate a potential role of normal liver transaminase levels in the decision algorithm in suspected pediatric blunt liver trauma...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27465848/treatment-practices-and-outcomes-after-blunt-cerebrovascular-injury-in-children
#19
Michael C Dewan, Vijay M Ravindra, Stephen Gannon, Colin T Prather, George L Yang, Lori C Jordan, David Limbrick, Andrew Jea, Jay Riva-Cambrin, Robert P Naftel
BACKGROUND: Pediatric blunt cerebrovascular injury (BCVI) lacks accepted treatment algorithms, and postinjury outcomes are ill defined. OBJECTIVE: To compare treatment practices among pediatric trauma centers and to describe outcomes for available treatment modalities. METHODS: Clinical and radiographic data were collected from a patient cohort with BCVI between 2003 and 2013 at 4 academic pediatric trauma centers. RESULTS: Among 645 pediatric patients evaluated with computed tomography angiography for BCVI, 57 vascular injuries (82% carotid artery, 18% vertebral artery) were diagnosed in 52 patients...
December 2016: Neurosurgery
https://www.readbyqxmd.com/read/27444361/surgical-treatment-of-abdominal-aortic-aneurysms-in-infancy-and-early-childhood
#20
Jonathan L Eliason, Dawn M Coleman, Enrique Criado, James C Stanley
OBJECTIVE: Pediatric abdominal aortic aneurysms (AAAs) are rare. The intent of this report was to review the presentation and surgical management of AAAs in infancy and early childhood. METHODS: The clinical courses of young children undergoing AAA surgery were subjected to a retrospective review and analysis. RESULTS: Eleven children, nine boys and two girls, ranging in age from 2 weeks to 6 years, underwent surgical treatment of AAA at the University of Michigan from 2002 to 2014...
July 18, 2016: Journal of Vascular Surgery
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