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https://www.readbyqxmd.com/read/29350370/operative-and-non-operative-management-of-children-with-abdominal-gunshot-injuries
#1
Mehmet Şerif Arslan, Hikmet Zeytun, Serkan Arslan, Erol Basuguy, Mehmet Hanifi Okur, Bahattin Aydoğdu, Cemil Göya, İbrahim Uygun, Selçuk Otçu
BACKGROUND: Non-operative management (NOM) is a standard treatment method for solid organ injuries worldwide. There is no consensus on the management of gunshot wounds (GSW) because of the higher frequency of hollow viscus injuries (HVI) and the unpredictable depth of tissue damage produced by kinetic energy transfer during retardation of the bullet. Here we aimed to reevaluate indications for surgery and NOM based on our pediatric patients with abdominal GSW. METHODS: We performed a retrospective analysis of patients evaluated and treated for abdominal GSW at University of Dicle between January 2010 and October 2016...
January 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29349437/staged-endovascular-repair-of-an-abdominal-aortic-aneurysm-adjacent-to-a-chronic-high-flow-iliocaval-traumatic-arteriovenous-fistula
#2
S Keisin Wang, Ashley R Gutwein, Tom Casciani, Michael P Murphy, Gary W Lemmon
Large-vessel chronic traumatic arteriovenous fistulas are a rare complication after trauma. Delayed presentation can consist of one or more features of high-output cardiac failure, pulsatile abdominal mass, bruit, limb ischemia, and venous congestion. We describe a patient with a complex iliocaval fistula secondary to a remote gunshot wound associated with a large 8.5-cm aortic aneurysm. Informed consent of the patient was obtained for publication of the case.
December 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349418/femoral-artery-embolism-of-bullet-after-thoracic-gunshot-wound
#3
Rodrigo Machado Landim, Antônio Wilon Evelyn Soares Filho, Daniel Linhares Cardoso
No abstract text is available yet for this article.
September 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349397/femoral-artery-embolization-of-a-thoracic-stray-bullet
#4
Tanous Aoun, Fikani Amine, Khabbaz Ziad
Arterial bullet embolization after a thoracic gunshot wound represents a diagnostic and therapeutic challenge. The absence of an apparent exit wound should alert the clinician. Cardiac bullet injuries are mostly fatal. However, in some cases, patients may remain stable, and conservative management can be an acceptable strategy. We present a case report of a 7.62- × 39-mm thoracic stray bullet that embolized to the femoral artery.
September 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29341846/primary-intra-medullary-nailing-of-open-tibia-fractures-caused-by-low-velocity-gunshots-does-operative-debridement-increase-infection-rates
#5
Chester J Donnally, Charles M Lawrie, Jonathan I Sheu, Meredith A Gunder, Stephen M Quinnan
BACKGROUND: Although gunshot-induced extremity fractures are typically not considered open fractures, there is controversy regarding wound management in the setting of operative fixation to limit infection complications. Previous studies have evaluated the need for a formal irrigation and debridement (I&D) prior to intra-medullary nailing (IMN) of gunshot-induced femur fractures but none have specifically evaluated tibias. By comparing primary IMN for tibial shaft fractures caused by low-velocity firearms additionally treated with a formal operative I&D (group 1) with those without an I&D (group 2), we sought to identify whether there are: differences in treatment group infection rates; particular fracture patterns more prone to infection; and patient characteristics more prone to infections...
January 17, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29336747/traumatic-arteriovesical-fistula-from-the-external-iliac-artery-after-gunshot-wound-to-the-pelvis
#6
Erika Simmerman, Andrew Lawson, Ashley Schlafstein, Ashley Williams, Steven Holsten
No abstract text is available yet for this article.
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29334570/the-effect-of-prehospital-transport-time-injury-severity-and-blood-transfusion-on-survival-of-us-military-casualties-in-iraq
#7
Russ S Kotwal, Laura L F Scott, Jud C Janak, Bruce W Tarpey, Jeffrey T Howard, Edward L Mazuchowski, Frank K Butler, Stacy A Shackelford, Jennifer M Gurney, Zsolt T Stockinger
BACKGROUND: Reducing time from injury to care can optimize trauma patient outcomes. A previous study of prehospital transport of US military casualties during the Afghanistan conflict demonstrated the importance of time and treatment capability for combat casualty survival. METHODS: A retrospective descriptive analysis was conducted to analyze battlefield data collected on US military combat casualties during the Iraq conflict from March 19, 2003 to August 31, 2010...
January 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29320540/discerning-suicide-in-drug-intoxication-deaths-paucity-and-primacy-of-suicide-notes-and-psychiatric-history
#8
Ian R H Rockett, Eric D Caine, Hilary S Connery, Gail D'Onofrio, David J Gunnell, Ted R Miller, Kurt B Nolte, Mark S Kaplan, Nestor D Kapusta, Christa L Lilly, Lewis S Nelson, Sandra L Putnam, Steven Stack, Peeter Värnik, Lynn R Webster, Haomiao Jia
OBJECTIVE: A paucity of corroborative psychological and psychiatric evidence may be inhibiting detection of drug intoxication suicides in the United States. We evaluated the relative importance of suicide notes and psychiatric history in the classification of suicide by drug intoxication versus firearm (gunshot wound) plus hanging/suffocation-the other two major, but overtly violent methods. METHODS: This observational multilevel (individual/county), multivariable study employed a generalized linear mixed model (GLMM) to analyze pooled suicides and undetermined intent deaths, as possible suicides, among the population aged 15 years and older in the 17 states participating in the National Violent Death Reporting System throughout 2011-2013...
2018: PloS One
https://www.readbyqxmd.com/read/29319406/completed-suicide-in-an-autopsy-confirmed-case-of-early-onset-alzheimer-s-disease
#9
Jennifer Wiener Hartzell, Richard Geary, Kymberly Gyure, Venkata Ravi Chivukula, Marc W Haut
We report a case of a 57-year-old male with clinically diagnosed and autopsy-confirmed early onset Alzheimer's disease who completed suicide by gunshot wound to the chest. This case has several unique aspects that have not been discussed in previous case reports of completed suicide in Alzheimer's disease. In particular, our patient's death was highly planned with successful compensation for his cognitive deficits. After all firearms had been removed from the home as a safety precaution, he obtained a new weapon, hid it and left himself cues to find and use it...
January 10, 2018: Neurodegenerative Disease Management
https://www.readbyqxmd.com/read/29307927/tomographic-aspects-of-penetrating-thoracic-trauma-injuries-from-firearms-and-other-weapons
#10
Alessandro Severo Alves de Melo, Luiza Beatriz Melo Moreira, Fernanda Miraldi Clemente Pessoa, Nara Saint-Martin, Roger Ancilotti Filho, Arthur Soares Souza, Edson Marchiori
Objective: The aim of this study was to analyze the various computed tomography findings in penetrating chest trauma, as well as to determine the frequency and extent of the lesions. Material and Methods: We studied the computed tomography findings from 40 cases of penetrating thoracic trauma, of which 35 (85.8%) were gunshot wounds and 5 (14.2%) were caused by another type of weapon. Results: Pulmonary lesions were found in 39 cases (97.5%), manifesting as contusions in 34 cases (85%), atelectasis in 8 (20%), lacerations in 1 (2...
November 2017: Radiologia Brasileira
https://www.readbyqxmd.com/read/29301804/recurrent-hospitalisations-in-a-rare-case-of-hemicorporectomy-a-challenging-case-for-medical-management
#11
Ajit Thakur, Brittney Elliott, Rohan Naik, Nabeel Khan, Shayna McQuaid, Camelia Arsene
Hemicorporectomy, or translumbar amputation, is a radical surgery involving the dissection of the body at the waist and is usually reserved for complex medical conditions including locally invasive malignancy and terminal pelvic osteomyelitis. Only 71 cases have previously been reported. We present a rare case of hemicorporectomy in a 53-year-old patient with terminal pelvic osteomyelitis which occurred after he suffered a gunshot wound at T6 causing paraplegia at the age of 31. Unfortunately, this patient continued to suffer recurrent hospitalisations and sepsis events secondary to chronic, non-healing advanced pressure ulcers and complicated urinary tract infections despite repeated courses of broad-spectrum intravenous antibiotics and surgical debridements...
January 4, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29287924/the-effect-of-a-concomitant-renal-injury-on-the-outcome-of-colonic-trauma
#12
G V Oosthuizen, R Weale, V Y Kong, J L Bruce, R J Urry, G L Laing, D L Clarke
BACKGROUND: The management of colon injuries has steadily evolved over the course of the last half century. So too has the management of renal trauma. It is not clear from the literature as to whether concomitant colon and renal injuries carry increased risk of morbidity and mortality, and whether this combination of injuries necessitates a specifically tailored management approach. METHODS: A retrospective review was carried out for the period January 2012 to December 2016...
December 6, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29283002/twenty-three-years-1993-2015-of-homicide-trends-in-the-transkei-region-of-south-africa
#13
Meel Banwari
Background Transkei is regarded as a rural part of South Africa. It was one of the black homelands where rigorous apartheid was practised. The incidence of firearm-related deaths used to be very high, but after the implementation of the Firearm Control Act in 2002, the trend changed. However, the murder rate is still a major public-health problem in this region of South Africa. Objective The aim of this study was to investigate 23 years (1993-2015) of homicide trends in the Transkei region of South Africa. Method A review of records of medico-legal autopsies performed at Mthatha Forensic Pathology Laboratory from 1993 to 2015 was undertaken...
January 1, 2017: Medicine, Science, and the Law
https://www.readbyqxmd.com/read/29262416/consensus-on-wound-antisepsis-update-2018
#14
Axel Kramer, Joachim Dissemond, Simon Kim, Christian Willy, Dieter Mayer, Roald Papke, Felix Tuchmann, Ojan Assadian
Wound antisepsis has undergone a renaissance due to the introduction of highly effective wound-compatible antimicrobial agents and the spread of multidrug-resistant organisms (MDROs). However, a strict indication must be set for the application of these agents. An infected or critically colonized wound must be treated antiseptically. In addition, systemic antibiotic therapy is required in case the infection spreads. If applied preventively, the Wounds-at-Risk Score allows an assessment of the risk for infection and thus appropriateness of the indication...
December 21, 2017: Skin Pharmacology and Physiology
https://www.readbyqxmd.com/read/29261590/use-of-open-and-endovascular-surgical-techniques-to-manage-vascular-injuries-in-the-trauma-setting-a-review-of-the-aast-proovit-registry
#15
Edwin R Faulconer, Bernardino C Branco, Melissa N Loja, Kevin Grayson, James Sampson, Timothy C Fabian, John B Holcomb, Thomas Scalea, David Skarupa, Kenji Inaba, Nathaniel Poulin, Todd E Rasmussen, Joseph J Dubose
INTRODUCTION: Vascular trauma data have been submitted to the American Association for the Surgery of Trauma PROspective Observational Vascular Injury Trial (PROOVIT) database since 2013. We present data to describe current use of endovascular surgery in vascular trauma. METHODS: Registry data from March 2013 to December 2016 were reviewed. All trauma patients who had an injury to a named artery, except the forearm and lower leg, were included. Arteries were grouped into anatomic regions and by compressible and non-compressible region for analysis...
December 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29260242/-update-on-gunshot-wounds-to-extremities
#16
F von Lübken, G Achatz, B Friemert, M Mauser, A Franke, E Kollig, D Bieler
Due to recent rampage and terror attacks in Europe, gunshot wounds have become a focus of attention even though they are still rare in Europe. Approximately 50% of gunshot wounds affect the extremities and to understand the sequelae, a basic knowledge of wound ballistics is indispensable. The energy transmitted from the bullet to the tissue is responsible for the severity of the injury and is dependent on the type of weapon and ammunition. A differentiation is made between low-energy injuries caused, e.g...
December 19, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/29225120/retained-bullet-in-the-kidney-imaging-and-conservative-management
#17
Guglielmo Mantica, Stephan Kruger, Hilgard Ackermann, Pieter V Spies, Farzana Cassim, Zamira Keyser, Carlo Terrone, André van der Merwe
Renal gunshot wounds resulting in a grade IV injury (AAST) should be explored only if they involve the hilum or if there are signs of suspected renal pelvis or ureteral laceration, active haemorrhage, peritonitis or hemodynamically unstable patients.1 However, due to the paucity of cases reported in the literature, it is not clear what the best management of patients with a retained bullet is, which have been traditionally treated with surgical retrieval in other organs. We present the radiological findings and a clinical case summary of a patient with Grade IV kidney injury and retained bullet managed conservatively...
December 7, 2017: Urology
https://www.readbyqxmd.com/read/29210725/airway-management-in-a-patient-with-tracheal-disruption-due-to-penetrating-neck-trauma-with-hollow-point-ammunition-a-case-report
#18
Angela M Johnson, James L Hill, Dave J Zagorski, Joseph M McClain, Nicole C Maronian
Rapid sequence induction and intubation was performed for a patient in respiratory distress after a gunshot wound to the neck. Resistance was noted distal to vocal cords. With a bronchoscope unavailable, the endotracheal tube was advanced with a corkscrew maneuver. Subcutaneous emphysema had developed. The endotracheal tube was advanced into the right mainstem with adequate ventilation. Imaging illustrated tracheoesophageal injury. The patient was emergently explored. An intraluminal bullet was removed, lateral wall tracheal defect was repaired, and a tracheostomy was placed...
November 27, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29203201/combat-related-acetabular-fractures-outcomes-of-open-versus-closed-injuries
#19
Richard L Purcell, Michael A Donohue, Sameer K Saxena, Wade T Gordon, Louis L Lewandowski
INTRODUCTION: Since the onset of the Global War on Terror close to 50,000 United States service members have been injured in combat, many of these injuries would have previously been fatal. Among these injuries, open acetabular fractures are at an increased number due to the high percentage of penetrating injuries such as high velocity gunshot wounds and blast injuries. These injuries lead to a greater degree of contamination, and more severe associated injuries. There is a significantly smaller proportion of the classic blunt trauma mechanism typically seen in civilian trauma...
December 1, 2017: Injury
https://www.readbyqxmd.com/read/29194100/hematomas-in-tiger-territory-an-endovascular-alternative-to-wading-in
#20
Desarom Teso, Benjamin J Rogoway, Yolanda L Vea, Judson E Threlkeld, George R Dulabon, Riyad C Karmy-Jones
A 26-year-old man presented with gunshot wound to the epigastrium. At surgery, he was hemodynamically stable and had a tense hematoma with thrill in zone 2 (right side) and porta triad. After liver injury was controlled, he underwent percutaneous stenting of a renal artery-vena cava fistula and the hepatic artery injury was followed. Historically, penetrating injury to zone 2 has mandated operative exploration. However, with the advent of endovascular options, in stable patients, catheter-based options offer a reasonable alternative with less risk of blood loss and possible nephrectomy...
November 30, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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