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closed abdomen trauma

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https://www.readbyqxmd.com/read/29628670/bilateral-hip-dislocation-an-indicator-for-emergent-full-body-computed-tomography-scan-in-polytraumatized-patients-a-case-report-and-review-of-the-literature
#1
Benjamin Rufer, Marius Johann Baptist Keel, Beat Schnüriger, Moritz Caspar Deml
We present a rare case of traumatic bilateral asymmetric hip dislocation with pelvic fractures and a traumatic diaphragmatic hernia. A 53-year-old machinist was transferred to our emergency department with the suspicion of a bilateral hip dislocation after he was trapped between an elevator and the roof. Immediate closed reduction of the hips was not performed because of the expected risk of increasing hemodynamic instability with muscular relaxation. An emergent full-body computed tomography (CT) scan was made to assess injuries with need for further operative treatment...
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29601081/outcome-of-open-abdominal-management-following-military-trauma
#2
S Pengelly, J E A Berry, S E Herrick, D M Bowley, G L Carlson
BACKGROUND: Temporary abdominal closure (TAC) is increasingly common after military and civilian major trauma. Primary fascial closure cannot be achieved after TAC in 30 per cent of civilian patients; subsequent abdominal wall reconstruction carries significant morbidity. This retrospective review aimed to determine this morbidity in a UK military cohort. METHODS: A prospectively maintained database of all injured personnel from the Iraq and Afghanistan conflicts was searched from 1 January 2003 to 31 December 2014 for all patients who had undergone laparotomy in a deployed military medical treatment facility...
March 30, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29552394/diffuse-optical-monitoring-of-peripheral-tissues-during-uncontrolled-internal-hemorrhage-in-a-porcine-model
#3
Karthik Vishwanath, Rajan Gurjar, David Wolf, Suzannah Riccardi, Michael Duggan, David King
Reliable, continuous and noninvasive blood flow and hemoglobin monitoring in trauma patients remains a critical, but generally unachieved goal. Two optical sensing methods - diffuse correlation spectroscopy (DCS) and diffuse reflectance spectroscopy (DRS) - are used to monitor and detect internal hemorrhage. Specifically, we investigate if cutaneous perfusion measurements acquired using DCS and DRS in peripheral (thighs and ear-lobe) tissues could detect severe hemorrhagic shock in a porcine model. Four animals underwent high-grade hepato-portal injury in a closed abdomen, to induce uncontrolled hemorrhage and were subsequently allowed to bleed for 10 minutes before fluid resuscitation...
February 1, 2018: Biomedical Optics Express
https://www.readbyqxmd.com/read/29434652/the-open-abdomen-in-trauma-and-non-trauma-patients-wses-guidelines
#4
REVIEW
Federico Coccolini, Derek Roberts, Luca Ansaloni, Rao Ivatury, Emiliano Gamberini, Yoram Kluger, Ernest E Moore, Raul Coimbra, Andrew W Kirkpatrick, Bruno M Pereira, Giulia Montori, Marco Ceresoli, Fikri M Abu-Zidan, Massimo Sartelli, George Velmahos, Gustavo Pereira Fraga, Ari Leppaniemi, Matti Tolonen, Joseph Galante, Tarek Razek, Ron Maier, Miklosh Bala, Boris Sakakushev, Vladimir Khokha, Manu Malbrain, Vanni Agnoletti, Andrew Peitzman, Zaza Demetrashvili, Michael Sugrue, Salomone Di Saverio, Ingo Martzi, Kjetil Soreide, Walter Biffl, Paula Ferrada, Neil Parry, Philippe Montravers, Rita Maria Melotti, Francesco Salvetti, Tino M Valetti, Thomas Scalea, Osvaldo Chiara, Stefania Cimbanassi, Jeffry L Kashuk, Martha Larrea, Juan Alberto Martinez Hernandez, Heng-Fu Lin, Mircea Chirica, Catherine Arvieux, Camilla Bing, Tal Horer, Belinda De Simone, Peter Masiakos, Viktor Reva, Nicola DeAngelis, Kaoru Kike, Zsolt J Balogh, Paola Fugazzola, Matteo Tomasoni, Rifat Latifi, Noel Naidoo, Dieter Weber, Lauri Handolin, Kenji Inaba, Andreas Hecker, Yuan Kuo-Ching, Carlos A Ordoñez, Sandro Rizoli, Carlos Augusto Gomes, Marc De Moya, Imtiaz Wani, Alain Chichom Mefire, Ken Boffard, Lena Napolitano, Fausto Catena
Damage control resuscitation may lead to postoperative intra-abdominal hypertension or abdominal compartment syndrome. These conditions may result in a vicious, self-perpetuating cycle leading to severe physiologic derangements and multiorgan failure unless interrupted by abdominal (surgical or other) decompression. Further, in some clinical situations, the abdomen cannot be closed due to the visceral edema, the inability to control the compelling source of infection or the necessity to re-explore (as a "planned second-look" laparotomy) or complete previously initiated damage control procedures or in cases of abdominal wall disruption...
2018: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/29193022/experimental-study-of-delivery-of-humidified-warm-carbon-dioxide-during-open-abdominal-surgery
#5
S Carpinteri, S Sampurno, J Malaterre, R Millen, M Dean, J Kong, T Chittleborough, A Heriot, A C Lynch, R G Ramsay
BACKGROUND: The aim of this study was to monitor the effect of humidified-warm carbon dioxide (HWCO2 ) delivered into the open abdomen of mice, simulating laparotomy. METHODS: Mice were anaesthetized, ventilated and subjected to an abdominal incision followed by wound retraction. In the experimental group, a diffuser device was used to deliver HWCO2 ; the control group was exposed to passive air flow. In each group of mice, surgical damage was produced on one side of the peritoneal wall...
April 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29118676/host-responses-to-concurrent-combined-injuries-in-non-human-primates
#6
Matthew J Bradley, Diego A Vicente, Benjamin A Bograd, Erin M Sanders, Crystal L Leonhardt, Eric A Elster, Thomas A Davis
Background: Multi-organ failure (MOF) following trauma remains a significant cause of morbidity and mortality related to a poorly understood abnormal inflammatory response. We characterized the inflammatory response in a non-human primate soft tissue injury and closed abdomen hemorrhage and sepsis model developed to assess realistic injury patterns and induce MOF. Methods: Adult male Mauritan Cynomolgus Macaques underwent laparoscopy to create a cecal perforation and non-anatomic liver resection along with a full-thickness flank soft tissue injury...
2017: Journal of Inflammation
https://www.readbyqxmd.com/read/28958281/an-innovative-way-to-separate-gastrointestinal-and-abdominal-wall-reconstruction-after-complex-abdominal-trauma
#7
David H Livingston, David V Feliciano
Despite advances in trauma care, a subset of patients surviving damage control cannot achieve fascial closure and require split-thickness skin grafting (STSG) of their open abdomen. Controversy exists as to whether reconstruction of the gastrointestine (GI) should be staged or performed at the time of abdominal wall reconstruction (AWR). Many surgeons do not believe that operations through the STSG can be completed safely or without loss of graft. This series reviews the outcomes of operations for GI reconstruction performed through the elevated healed STSG...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28454986/old-tools-old-problems-new-solution-the-use-of-a-modified-cecil-culp-concept-in-the-trauma-setting
#8
Dana A Weiss, Zachary L Smith, Jesse A Taylor, Douglas A Canning
A 12-year-old boy sustained a close-range shotgun wound with buckshot to the penis and lower abdomen. The proximal two-thirds of the corpora cavernosa was obliterated and the distal third was thrombosed. All dorsal penile skin was lost. The urethra remained intact. The patient underwent multiple debridements, allowing the wound to declare its borders. Employing the tissue transfer concept used by Cecil and Culp in hypospadias repairs, the penis was marsupialized onto the suprapubic area where it remained for 8 months...
August 2017: Urology
https://www.readbyqxmd.com/read/28394751/practice-patterns-for-the-use-of-antibiotic-agents-in-damage-control-laparotomy-and-its-impact-on-outcomes
#9
Stephanie R Goldberg, Jennifer Henning, Luke G Wolfe, Therese M Duane
BACKGROUND: The purpose of this study was to identify practice patterns associated with the use of antimicrobial agents with damage control laparotomy (DCL) and the relationship with post-operative intra-abdominal infection (IAI) rates. PATIENTS AND METHODS: The study was a retrospective review of trauma patients undergoing laparotomy at a Level 1 trauma center in 2010. Patients undergoing DCL versus those primarily closed (PCL) were compared for antimicrobial use (ABX) and its correlation with IAI rates (p < 0...
April 2017: Surgical Infections
https://www.readbyqxmd.com/read/27855712/blood-pressure-and-heart-rate-during-ovariohysterectomy-in-pyometra-and-control-dogs-a-preliminary-investigation
#10
Odd Viking Höglund, Johanna Lövebrant, Ulf Olsson, Katja Höglund
BACKGROUND: Surgery causes a stress response, a physiologic response to trauma. The intraoperative surgical stress response in dogs diagnosed with pyometra has not previously been described. The aim of this study was to investigate the intraoperative surgical stress response, assessed by blood pressure and heart rate measurements, in dogs diagnosed with pyometra and healthy controls. All dogs were premedicated with acepromazine and methadone, anaesthesia was induced with propofol and maintained with isoflurane, where after the dogs were subjected to ovariohysterectomy...
November 17, 2016: Acta Veterinaria Scandinavica
https://www.readbyqxmd.com/read/27721201/idiopathic-omental-hemorrhage-a-case-report-and-review-of-the-literature
#11
Jiro Kimura, Kenji Okumura, Hideki Katagiri, Alan Kawarai Lefor, Ken Mizokami, Tadao Kubota
INTRODUCTION: Omental hemorrhage results from rupture of the omental vessels. There are many causes of omental hemorrhage including trauma, aneurysm, and vasculitis. Idiopathic omental hemorrhage is a rare cause of an acute abdomen, which is potentially life-threatening. We report a patient with idiopathic omental hemorrhage, which may have been caused by overeating. CASE PRESENTATION: A 29-year-old man without a history of trauma, bleeding disorders, or other significant medical history, presented with left upper quadrant pain, which began after overeating the previous evening...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27614337/strangulated-transmesosigmoid-hernia-as-a-late-complication-of-a-fall-from-a-height-a-case-report
#12
Shigehiro Kojima, Tsuguo Sakamoto, Masayuki Honda, Dal Ho Kim
INTRODUCTION: A transmesosigmoid hernia is defined as small bowel herniation through a complete defect involving both layers of the sigmoid mesentery. Blunt trauma injury to the sigmoid mesocolon has been reported only rarely. We herein report a case of a strangulated transmesosigmoid hernia associated with a history of a fall from a height. PRESENTATION OF CASE: A 43-year-old woman presented to our hospital for evaluation of vomiting. She had no history of abdominal surgery but had sustained a complete spinal cord injury and pelvic fracture secondary to a fall from a height 25 years earlier...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27584084/thoracic-splenosis-report-of-a-case-and-review-of-the-diagnostic-workup
#13
Walter Bugiantella, Federico Crusco, Nicola Avenia, Rondelli Fabio
UNLABELLED: Splenosis is the autoimplantation of splenic tissue to ectopic sites after spleen injury. Although splenosis most commonly occurs in the abdomen, it may occur in the thorax in case of diaphragm rupture. Thoracic splenosis (TS) is often asymptomatic and is diagnosed incidentally in the course of chest examination. We describe the case of a man, with a history of thoracoabdominal trauma, undergoing routine chest radiography with the evidence of radio-opaque images close to the inferior left curvature of the cardiac shadow, which resulted to be nodules of TS at the contrast enhanced CT scan...
July 29, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27547961/management-of-the-open-abdomen-clinical-recommendations-for-the-trauma-acute-care-surgeon-and-general-surgeon
#14
REVIEW
Luis G Fernández
Traditionally, the surgical approach to managing abdominal injuries was to assess the extent of trauma, repair any damage and close the abdomen in one definitive procedure rather than leave the abdomen open. With advances in medicine, damage control surgery using temporary abdominal closure methods is being used to manage the open abdomen (OA) when closure is not possible. Although OA management is often observed in traumatic injuries, the extension of damage control surgery concepts, in conjunction with OA, for the management of the septic patient requires that the general surgeon who is faced with these challenges has a comprehensive knowledge of this complex subject...
September 2016: International Wound Journal
https://www.readbyqxmd.com/read/27328580/idiopathic-pneumatosis-intestinalis-requiring-decompressive-laparotomy
#15
Andrew McGregor, Khaldoun Bekdache, Laura Choi
INTRODUCTION: Pneumatosis intestinalis (PI) and hepatic portal venous gas (HPVG) are radiographic signs of questionable bowel ischemia. Pneumatosis intestinalis can be associated with possible benign conditions such as obstructive airway disease. We present a patient who demonstrated clinical signs of overt sepsis with corresponding radiological findings of PI and HPVG concering for possible small or large bowel ischemia. However at exploration, no sign of small or large bowel injury or ischemia could be detected...
May 2016: Connecticut Medicine
https://www.readbyqxmd.com/read/27077468/a-case-of-suggested-ibuprofen-induced-acute-pancreatitis
#16
Maitham A Moslim, Thomas C Sodeman, Ali T Nawras
Drug-induced acute pancreatitis (DIP) is uncommon and may account for 2%-5% of cases, although the incidence may be increasing nowadays. DIP has been documented for more than 160 drugs in the literature. The most common nonsteroidal anti-inflammatory drugs (NSAIDs) that have been reported to cause pancreatitis are sulindac and salicylates. In this report, we present a case of probable ibuprofen-induced pancreatitis. A 60-year-old white woman presented with the sudden onset of mild acute pancreatitis (AP) 5 hours following the ingestion of 6 tablets of ibuprofen (Advil) 200 mg (equivalent to 20...
November 2016: American Journal of Therapeutics
https://www.readbyqxmd.com/read/27058153/inferior-hip-dislocation-after-falling-from-height-a-case-report
#17
Ali Çağrı Tekin, Haluk Çabuk, Cem Dinçay Büyükkurt, Süleyman Semih Dedeoğlu, Yunus İmren, Hakan Gürbüz
INTRODUCTION: Traumatic inferior hip dislocation is the least common of all hip dislocations. Adult inferior hip dislocations usually occur after high-energy trauma, very few cases are reported without fracture. PRESENTATION OF CASE: A 26-year-old female was brought to the emergency department with severe pain in the left hip, impaired posture and restricted movement following a fall from 15m height. The hip joint was fixed in 90° flexion, 15° abduction, and 20° external rotation...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27054636/staged-repair-of-severe-open-abdomens-due-to-high-energy-gunshot-injuries-with-early-vacuum-pack-and-delayed-tissue-expansion-and-dual-sided-meshes
#18
Doğan Alhan, İsmail Şahin, Serbülent Güzey, Andaç Aykan, Fatih Zor, Serdar Öztürk, Mustafa Nışancı, İsmail Hakkı Özerhan
BACKGROUND: Open abdomen is a salvage procedure that prevents catastrophes after severe intraabdominal traumas. However, following this life saving attempt, it is mostly not feasible to close the abdomen immediately after the recovery of intraabdominal injuries. Consequently, a staged reconstruction is required, and the first stage is usually a temporary closing approach. At the end of this stage, resulting giant "ventral hernia" is a burden for both the patient and the surgeon. Therefore a permanent repair is subsequently needed...
December 2015: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/26682843/ovarian-vein-thrombosis-in-a-polytrauma-patient
#19
Emma Toman, Alastair Beaven, Moji Balogun, Keith Porter
A young mother presented to a major trauma centre following a road traffic collision. Her admission CT traumagram demonstrated liver and renal lacerations, spinal and pelvic fractures with no abnormalities of the ovarian veins. Her inpatient course was uncomplicated other than a sustained, isolated raised C reactive protein. CT of the abdomen 1 week after injury demonstrated stable solid organ injuries and the additional, unexpected finding of a right ovarian vein thrombosis (OVT). A pragmatic approach was taken towards the management of the OVT given the haemorrhagic risk from her traumatic injuries...
December 18, 2015: BMJ Case Reports
https://www.readbyqxmd.com/read/26408935/treatment-of-delayed-jejunal-perforation-after-irreducible-femoral-hernia-repair-with-open-abdomen-management-and-delayed-abdominal-closure-with-skin-flap-approximation
#20
Fahri Yetişir, A Ebru Sarer, Hasan Zafer Acar, Omer Yazıcıoglu, Basar Basaran
INTRODUCTION: We show the management of a delayed jejunal perforation, after irreducible femoral hernia operation with the help of negative pressure therapy (NPT) and delayed abdominal closure (DAC) with skin flap approximation in an elderly woman for the first time in the literature. PRESENTATION OF CASE: A 76 year-old woman was admitted to the emergency department with irreducible femoral hernia and ileus. After examining the femoral hernia sac and noting the presence of viable intestine within the hernia sac, a femoral hernia repair with mesh was performed...
2015: International Journal of Surgery Case Reports
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