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Liver injury trauma penetrating

Leah Carey Tatebe, Andrew Jennings, Ken Tatebe, Alexandra Handy, Purvi Prajapati, Michael Smith, Tai Do, Gerald O Ogola, Rajesh R Gandhi, Therese M Duane, Stephen Luk, Laura Bruce Petrey
BACKGROUND: Delayed colonic anastomosis after damage control laparotomy (DCL) is an alternative to colostomies during a single laparotomy (SL) in high-risk patients. However, literature suggests increased colonic leak rates up to 27% with DCL, and various reported risk factors. We evaluated our regional experience to determine if delayed colonic anastomosis was associated with worse outcomes. METHODS: A multicenter retrospective cohort study was performed across three Level I trauma centers encompassing traumatic colon injuries from January 2006 through June 2014...
April 2017: Journal of Trauma and Acute Care Surgery
Abdul Q Alarhayem, Stephen M Cohn, Mark T Muir, John G Myers, James Fuqua, Brian J Eastridge
BACKGROUND: We sought to determine if aggressive resuscitation in trauma patients presenting without vital signs or "dead on arrival" (DOA) was futile. We also sought to determine if organ donation was an unexpected benefit of aggressive resuscitation. STUDY DESIGN: We conducted a review of adults presenting to our Level 1 trauma center with no signs of life (pulse = 0; systolic blood pressure = 0; and no evidence of neurologic activity, GCS = 3). Primary outcome was survival to hospital discharge or major organ donation (heart, lung, kidney, liver or pancreas were harvested)...
March 2, 2017: Journal of the American College of Surgeons
J Barrie, S Jamdar, M F Iniguez, O Bouamra, T Jenks, F Lecky, D A O'Reilly
BACKGROUND: Over the last decade trauma services have undergone a reconfiguration in England and Wales. The objective is to describe the epidemiology, management and outcomes for liver trauma over this period and examine factors predicting survival. METHODS: Patients sustaining hepatic trauma were identified using the Trauma Audit and Research Network database. Demographics, management and outcomes were assessed between January 2005 and December 2014 and analysed over five, 2-year study periods...
February 16, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Abdel Fattah Saleh, Emad Al Sageer, Amr Elheny
The aim of this study is to present the outcome of operative and non-operative management of patients with liver injury treated in a single institution depending on imaging. This study was conducted at the Causality Unit of Minia University Hospital, and included 60 patients with hepatic trauma from March 2012 to January 2013. In our study, males represent 80 % while females represent 20 % of the traumatized patients. The peak age for trauma found was 11-30 years. Blunt trauma is the most common cause of liver injury as it was the cause in 48 patients (80 %)...
December 2016: Indian Journal of Surgery
Leah Tatebe, Andrew Jennings, Ken Tatebe, Alexandra Handy, Purvi Prajapati, Michael Smith, Tai Do, Gerald O Ogola, Rajesh R Gandhi, Therese M Duane, Stephen Luk, Laura B Petrey
BACKGROUND: Delayed colonic anastomosis after damage control laparotomy (DCL) is an alternative to colostomies during a single laparotomy (SL) in high-risk patients. However, literature suggests increased colonic leak rates up to 27% with DCL, and various reported risk factors. We evaluated our regional experience to determine if delayed colonic anastomosis was associated with worse outcomes. METHODS: A multi-center retrospective cohort study was performed across three Level I Trauma Centers encompassing traumatic colon injuries from January 2006 through June 2014...
December 23, 2016: Journal of Trauma and Acute Care Surgery
A B van As, Alastair J W Millar
Of all the intra-abdominal solid organs, the liver is the most vulnerable to blunt abdominal trauma. The majority of liver ruptures present in combination with other abdominal or extra-abdominal injuries. Over the last three decades, the management of blunt liver trauma has evolved from obligatory operative to non-operative management in over 90% of cases. Penetrating liver injuries more often require operative intervention and are managed according to adult protocols. The greatest clinical challenge remains the timely identification of the severely damaged liver with immediate and aggressive resuscitation and expedition to laparotomy...
April 2017: Pediatric Surgery International
Zhang Fangbiao, Zheng Chunhui, Zhao Chun, Shi Hongcan, Zhang Xiangyan, Tu Shaosong
The aim of this retrospective study is to review our experience in the diagnosis and role of thoracotomy for traumatic diaphragmatic hernia (TDH). Between January 2008 and June 2014, 23 patients from Yangzhou Medical College (Yangzhou China) and Lishui Center Hospital (Lishui China), who underwent thoracotomy for TDH, were analyzed. The clinical features, imaging findings, operative findings, and outcome of treatment in these patients are presented. There were 23 patients (18 males and 5 females) who underwent surgical procedures due to TDH...
October 2016: Indian Journal of Surgery
Ki Tae Kim, Pil Won Seo
A 53-year-old man arrived at the trauma center with a steel bar penetrating from the epigastrium to the right scapula. He was hypotensive and hypoxic, and immediate resuscitation and basic evaluation were performed. An emergency operation was performed due to an unstable hemodynamic state. Multiple injuries were confirmed in the right lower lobe, posterior chest wall, diaphragm, and liver lateral segment. Right lower lobectomy and liver lateral sectionectomy were performed following removal of the bar. The patient recovered without additional hemorrhage after the surgery, and was transferred to a rehabilitation institution with periodic follow-up...
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Selim Bakan, Bora Korkmazer, Ahmet Baş, Osman Şimşek, Hasan Ali Barman, Deniz Çebi Olgun
Bullet embolism to the heart is a rare but serious complication of penetrating trauma. Distant migration of foreign bodies via the vascular system must be taken into consideration following penetrating gunshot trauma. Delays in diagnosis may result in poor management and subsequent complications that may lead to grave prognosis. Presently described was a conservatively managed case of asymptomatic intracardiac pellet embolization. Highlighted was the importance of serial scanning for intravascular migration of pellet following penetrating gunshot injury, in addition to conservative management in asymptomatic patients...
July 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Christina A LeBedis, David D B Bates, Jorge A Soto
Iatrogenic and traumatic bile leaks are uncommon. However, given the overall increase in number of hepatobiliary surgeries and the paradigm shift toward nonoperative management of patients with liver trauma, they have become more prevalent in recent years. Imaging is essential to establishing early diagnosis and guiding treatment as the clinical signs and symptoms of bile leaks are nonspecific, and a delay in recognition of bile leaks portends a high morbidity and mortality rate. Findings suspicious for a bile leak at computed tomography or ultrasonography include free or contained peri- or intrahepatic low density fluid in the setting of recent trauma or hepatobiliary surgery...
January 2017: Abdominal Radiology
Wong Hoi She, Tan To Cheung, Wing Chiu Dai, Simon H Y Tsang, Albert C Y Chan, Daniel K H Tong, Gilberto K K Leung, Chung Mau Lo
AIM: To review the outcomes of liver trauma in patients with hepatic injuries only and in patients with associated injuries outside the liver. METHODS: Data of liver trauma patients presented to our center from January 2003 to October 2013 were reviewed. The patients were divided into two groups. Group 1 consisted of patients who had hepatic injuries only. Group 2 consisted of patients who also had associated injuries outside the liver. RESULTS: Seven (30...
May 28, 2016: World Journal of Hepatology
Mitre Kalil, Isaac Massaud Amim Amaral
OBJECTIVE: to evaluate the epidemiological variables and diagnostic and therapeutic modalities related to hepatic trauma patients undergoing laparotomy in a public referral hospital in the metropolitan region of Vitória-ES. METHODS: we conducted a retrospective study, reviewing charts of trauma patients with liver injuries, whether isolated or in association with other organs, who underwent exploratory laparotomy, from January 2011 to December 2013. RESULTS: We studied 392 patients, 107 of these with liver injury...
February 2016: Revista do Colégio Brasileiro de Cirurgiões
Valary T Raup, Jairam R Eswara, Joel M Vetter, Steven B Brandes
OBJECTIVE: To analyze adrenal injuries using the National Trauma Data Bank. Adrenal trauma is rare and current literature is lacking in data from large case series. METHODS: A retrospective analysis of the National Trauma Data Bank from the years 2007-2011 was performed. Patient demographics, Injury Severity Score (ISS), mechanism of injury, type of trauma, associated injuries, and development of shock were assessed. Multivariable models were used to determine association with outcomes, such as characterization of injury, need for adrenalectomy, intensive care unit admission, and death...
August 2016: Urology
Marcel A Machado, Rodrigo C Surjan, Tiago Basseres, Fábio F Makdissi
Modern liver techniques allowed the development of segment-based anatomical liver resections. Nevertheless, there is still a place for nonanatomical liver resections. However, in some cases, there is a need for enucleation of deep located liver tumors. The main problem with enucleation of a liver tumor deeply located in the middle of the liver is the control of bleeding resulting from the rupture of small or medium vessels. The authors describe a simple way to control the bleeding without the use of any special instrument or material...
2016: Journal of Surgical Case Reports
Theofano Eftaxiopoulou, Ashton Barnett-Vanes, Hari Arora, Warren Macdonald, Thuy-Tien N Nguyen, Mako Itadani, Anna E Sharrock, David Britzman, William G Proud, Anthony M J Bull, Sara M Rankin
BACKGROUND: Blast injuries from conventional and improvised explosive devices account for 75% of injuries from current conflicts; over 70% of injuries involve the limbs. Variable duration and magnitude of blast wave loading occurs in real-life explosions and is hypothesised to cause different injuries. While a number of in vivo models report the inflammatory response to blast injuries, the extent of this response has not been investigated with respect to the duration of the primary blast wave...
March 2016: Injury
I Negoi, S Paun, B Stoica, I Tanase, S Hostiuc, M Beuran
INTRODUCTION: The pancreatic injuries have fortunately a low frequency, but when present associate multiple intraabdominal lesions, and carry a significant morbidity and mortality. The aim of this study is to underline the significant morbidity associated with high grade pancreatic injuries. CASE REPORT: Female patient, 36 years old, with penetrating abdominal trauma due to domestic violence was referred to our center from a regional county hospital, after multiple laparotomies, hemodynamically unstable, with multiple organ failure...
November 2015: Chirurgia
Natalie Durkin, Annamaria Deganello, Maria E Sellars, Paul S Sidhu, Mark Davenport, Erica Makin
BACKGROUND: Pseudoaneurysm (PA) formation following blunt and penetrating abdominal trauma is a recognized complication in solid organ injury, usually diagnosed by contrast-enhanced CT (CECT) imaging. Delayed rupture is a potentially life-threatening event, although its frequency is not known in pediatric trauma. Contrast enhanced ultrasound (CEUS) is a novel radiation-free alternative to CECT with the potential to identify PA. METHODS: A retrospective review of consecutive cases of significant liver and splenic injuries admitted to single institution (tertiary and quaternary referrals) over more than a 12year period was performed...
February 2016: Journal of Pediatric Surgery
Angela Oyo-Ita, Paul Chinnock, Ikpeme A Ikpeme
BACKGROUND: Injury to the abdomen can be blunt or penetrating. Abdominal injury can damage internal organs such as the liver, spleen, kidneys, intestine, and large blood vessels. There are controversies about the best approach to manage abdominal injuries. OBJECTIVES: To assess the effects of surgical and non-surgical interventions in the management of abdominal trauma in a haemodynamically stable and non-peritonitic abdomen. SEARCH METHODS: We searched the Cochrane Injuries Group's Specialised Register, The Cochrane Library, Ovid MEDLINE(R), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R), EMBASE Classic+EMBASE (Ovid), ISI WOS (SCI-EXPANDED, SSCI, CPCI-S & CPSI-SSH), CINAHL Plus (EBSCO), and clinical trials registers, and screened reference lists...
November 13, 2015: Cochrane Database of Systematic Reviews
O Dandin, E J Valle, G Pimentha, C I Schulman, U Teomete, K G Proctor, N Namias
OBJECTIVES: Liver abscesses are approximately 50 % of all visceral abscesses, and trauma presents as a rare cause of the liver abscess. Otherwise, hepatic abscess is an uncommon complication of gunshot wound (GSW) to the liver among all trauma cases. Here we reviewed their experience in detail. METHOD: From January 1, 2004 to September 30, 2013, there were 2143 patients admitted to Ryder Trauma Center at Jackson Memorial Hospital/University of Miami with severe abdominal trauma: 1227 penetrating and 866 blunt...
November 2016: Irish Journal of Medical Science
Jun Liu, Wei-Dong Yue, Ding-Yuan Du
PURPOSE: To investigate the diagnostic value of multi-slice computed tomography (MSCT) for combined thoracoabdominal injury. METHODS: A retrospective study was conducted to analyze the clinical data and MSCT images of 68 patients who sustained a combined thoracoabdominal injury associated with diaphragm rupture, and 18 patients without diaphragm rupture. All the patients were admitted and treated in the Chongqing Emergency Medical Center (a level I trauma center) between July 2005 and February 2014...
2015: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
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