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Blunt abdominal trauma

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https://www.readbyqxmd.com/read/28932702/emergency-ct-of-blunt-abdominal-trauma-experience-from-a-large-urban-hospital-in-southern-china
#1
REVIEW
Jingshan Gong, Dongdong Mei, Minjie Yang, Jianmin Xu, Yangyang Zhou
Trauma is one of the leading causes of death for men and women under the age of 45 years old, and abdominal injuries contribute to a large number of these deaths. Prompt diagnosis is very important for treatment decision making and can be life-saving. CT has become an essential imaging modality in emergency medicine. In this pictorial review, we present our experience of CT in blunt abdominal trauma and describe CT findings of common injuries, including hemoperitoneum, solid viscera, hollow viscera, mesenteric and diaphragmatic injuries...
August 2017: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28932700/endovascular-management-of-arterial-injuries-after-blunt-or-iatrogenic-renal-trauma
#2
REVIEW
Romaric Loffroy, Olivier Chevallier, Sophie Gehin, Marco Midulla, Pierre-Emmanuel Berthod, Christophe Galland, Pascale Briche, Céline Duperron, Nabil Majbri, Christiane Mousson, Nicolas Falvo
The kidney is the third most common abdominal organ to be injured in trauma, following the spleen and liver, respectively. The most commonly used classification scheme is the American Association for the Surgery of Trauma (AAST) classification of blunt renal injuries, which grades renal injury according to the size of laceration and its proximity to the renal hilum. Arteriovenous fistula and pseudoaneurysm are the most common iatrogenic biopsy-related or surgery-related vascular injuries in native kidneys. The approach to renal artery injuries has changed over time from more aggressive intervention to more conservative observational or endovascular management, including selective transcatheter arterial embolization (TAE) and the placement of stents/stent grafts...
August 2017: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28930954/acute-procedural-interventions-after-pediatric-blunt-abdominal-trauma-a-prospective-multicenter-evaluation
#3
Chase A Arbra, Adam M Vogel, Jingwen Zhang, Patrick D Mauldin, Eunice Y Huang, Kate B Savoie, Matthew T Santore, KuoJen Tsao, Tiffany G Ostovar-Kermani, Richard A Falcone, M Sidney Dassinger, John Recicar, Jeffrey H Haynes, Martin L Blakely, Robert T Russell, Bindi J Naik-Mathuria, Shawn D St Peter, David P Mooney, Chinwendu Onwubiko, Jeffrey S Upperman, Christian J Streck
BACKGROUND: Pediatric intra-abdominal injuries (IAI) from blunt abdominal trauma (BAT) rarely require emergent intervention. For those children undergoing procedural intervention, our aim was to understand the timing and indications for operation and angiographic embolization. METHODS: We prospectively enrolled children younger than 16 years after BAT at 14 Level I Pediatric Trauma Centers over a 1-year period. Patients with IAI who received an intervention (IAI-I) were compared with those who did not receive an intervention using descriptive statistics and univariate analysis; p less than 0...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930944/negative-ct-can-safely-rule-out-clinically-significant-intra-abdominal-injury-in-the-asymptomatic-patient-after-blunt-trauma-prospective-evaluation-of-1193-patients
#4
Elizabeth Benjamin, Jayun Cho, Gustavo Recinos, Evren Dilektasli, Lydia Lam, John Brunner, Kenji Inaba, Demetrios Demetriades
BACKGROUND: Computed tomography of the abdomen and pelvis (CTAP) is highly specific for injury identification and commonly used in the evaluation of blunt trauma patients. Despite this, there is no consensus on the required clinical observation period after negative imaging, often impacting patient flow and hospital cost. The purpose of this study was to evaluate the use of CTAP after blunt trauma and the need for observation following negative imaging. METHODS: A prospective analysis at a large level I trauma center was conducted from 11/2014-5/2015...
September 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28917584/pneumatoceles-in-pediatric-blunt-trauma-common-and-benign
#5
Lindsey B Armstrong, David P Mooney
INTRODUCTION: Traumatic pneumatoceles are reported to be rare in children and to have an uncertain clinical significance. We report a single institution series of traumatic pneumatoceles to better define their frequency and clinical significance. METHODS: After obtaining approval from the IRB, data were extracted from the trauma registry of a level 1 pediatric trauma center on children diagnosed with a pulmonary contusion (International Classification of Diseases-9th edition diagnosis codes: 861...
August 7, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28912997/laparoscopic-repair-of-diaphragmatic-rupture-a-case-report-with-radiological-and-surgical-correlation
#6
Patrick Nguyen, Bonnie Davis, Daniel D Tran
The leading cause of diaphragmatic rupture is penetrating abdominal trauma, including gunshot- and stab-related wounds; however, diaphragmatic rupture can also result from blunt trauma to the abdomen. The diagnosis can be difficult to make as the physical examination may be unremarkable, and imaging, that is, a conventional chest X-ray and/or CT imaging, may initially fail to reveal the injury. Failure to recognize diaphragmatic rupture can result in a delayed presentation, sometimes years later, with a potential catastrophic outcome...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28910356/recent-trends-in-30-day-mortality-in-patients-with-blunt-splenic-injury-a-nationwide-trauma-database-study-in-japan
#7
Chie Tanaka, Takashi Tagami, Hisashi Matsumoto, Kiyoshi Matsuda, Shiei Kim, Yuta Moroe, Reo Fukuda, Kyoko Unemoto, Hiroyuki Yokota
BACKGROUND: Splenic injury frequently occurs after blunt abdominal trauma; however, limited epidemiological data regarding mortality are available. We aimed to investigate mortality rate trends after blunt splenic injury in Japan. METHODS: We retrospectively identified 1,721 adults with blunt splenic injury (American Association for the Surgery of Trauma splenic injury scale grades III-V) from the 2004-2014 Japan Trauma Data Bank. We grouped the records of these patients into 3 time phases: phase I (2004-2008), phase II (2009-2012), and phase III (2013-2014)...
2017: PloS One
https://www.readbyqxmd.com/read/28899768/missed-opportunities-to-decrease-radiation-exposure-in-children-with-renal-trauma
#8
Thomas W Gaither, Mohannad A Awad, Natalia V Leva, Gregory P Murphy, Benjamin N Breyer, Hillary L Copp
BACKGROUND: Efforts have been made to reduce computed tomography (CT) scans in children with blunt abdominal injury. CT scans may be over utilized in pediatric patients with renal trauma. METHODS: We performed a retrospective chart review of all renal trauma cases (<18 years old) in two urban trauma centers from 2002-2016. We collected patient demographic and clinical characteristics, renal trauma grades, urologic interventions, and the timing and utilization of CT scans and renal ultrasounds...
September 9, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28899564/avoiding-delayed-diagnosis-of-significant-blunt-bowel-and-mesenteric-injuries-can-a-scoring-tool-make-the-difference-a-7-year-retrospective-cohort-study
#9
Tobias Zingg, Fabio Agri, Mylène Bourgeat, Bertrand Yersin, Benoît Romain, Sabine Schmidt, Nathalie Keller, Nicolas Demartines
INTRODUCTION: Significant blunt bowel and mesenteric injuries (sBBMI) are frequently missed despite the widespread use of computed tomography (CT). Early treatment improves the outcome related to these injuries. The aim of this study was to assess the prevalence of sBBMI, the incidence of delayed diagnosis and to test the performance of the Bowel Injury Prediction Score (BIPS), determined by the white blood cell (WBC) count, presence or absence of abdominal tenderness and CT grade of mesenteric injury...
September 6, 2017: Injury
https://www.readbyqxmd.com/read/28898314/-associated-factors-to-non-operative-management-failure-of-hepatic-and-splenic-lesions-secondary-to-blunt-abdominal-trauma-in-children
#10
Adriana Echavarria Medina, Carlos Hernando Morales Uribe, Luis Guillermo Echavarria R, Viviana María Vélez Marín, Jorge Alberto Martínez Montoya, David Fernando Aguillón
INTRODUCTION: The non operative management (NOM) is the standard management of splenic and liver blunt trauma in pediatric patients.Hemodynamic instability and massive transfusions have been identified as management failures. Few studies evaluate whether there exist factors allowing anticipation of these events. The objective was to identify factors associated with the failure of NOM in splenic and liver injuries for blunt abdominal trauma. PATIENTS AND METHOD: Retrospective analysis between 2007-2015 of patients admitted to the pediatric surgery at University Hospital Saint Vincent Foundation with liver trauma and/or closed Spleen...
2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28886723/pancreatic-injury-in-children-a-case-report-and-review-of-the-literature
#11
Fayza Haider, Mohammed Amin Al Awadhi, Eizat Abrar, Mooza Al Dossari, Hasan Isa, Husain Nasser, Hakima Al Hashimi, Sharif Al Arayedh
BACKGROUND: Trauma is the main cause of morbidity and mortality in the pediatric population. Blunt trauma to the abdomen accounts for the majority of abdominal injuries in children. Pancreatic injury, although uncommon (2 to 9%), is the fourth most common solid organ injury. Unlike other solid organ injuries, pancreatic trauma may be subtle and difficult to diagnose. Computed tomography currently is the imaging modality of choice. As the incidence of pancreatic injury in children sustaining blunt abdominal trauma is low, management remains a challenge...
September 9, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28886391/combined-pancreatic-and-duodenal-transection-injury-a-case-report
#12
Simbarashe Gift Mungazi, Chenesa Mbanje, Onesai Chihaka, Noah Madziva
INTRODUCTION: Combined pancreatic-duodenal injuries in blunt abdominal trauma are rare. These injuries are associated with high morbidity and mortality, and their emergent management is a challenge. CASE PRESENTATION: We report a case of combined complete pancreatic (through the neck) and duodenal (first part) transections in a 24-year-old male secondary to blunt abdominal trauma following a motor vehicle crash. The duodenal stumps were closed separately and a gastrojejunostomy performed for intestinal continuity...
August 31, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28876669/the-role-of-ct-scan-in-penetrating-abdominal-trauma
#13
S Patel, Z M Koto, M Balabyeki
BACKGROUND: Penetrating abdominal trauma contributes significantly to the burden of disease in South Africa. The role of imaging, particularly CT scan in this subset of patients has yet to be established. A correlation between imaging and intraoperative findings could assist with providing a framework for nonoperative management of patients with penetrating abdominal trauma. The role of imaging in blunt abdominal trauma has been established particularly in the patient who is haemodynamically stable...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876662/the-role-of-laparoscopy-in-blunt-abdominal-trauma-diagnostic-therapeutic-or-both
#14
M Z Koto, F Mosai, O Y Matsevych
BACKGROUND: The use of laparoscopy in blunt abdominal trauma is gaining popularity as a useful diagnostic tool to avoid unnecessary laparotomies where there is diagnostic dilemma. But the feasibility of using laparoscopy for therapeutic intervention in these patients has been debated. Even though recent case reports seem to suggest that these patients can be managed using laparoscopy, the practice is not yet wildly adopted. METHOD: A retrospective analysis of a prospectively collected data was done...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876606/trauma-laparoscopy-when-to-start-and-when-to-convert
#15
O Matsevych, M Koto, M Balabyeki, C Aldous
BACKGROUND: The use of laparoscopy for stable patients with abdominal trauma is increasing and its accuracy is nearly 100%. However, indications for laparoscopy and for conversion differ among centres. The aim of this study was to investigate indications for trauma laparoscopy and for conversion to laparotomy. METHOD: All trauma patients managed with laparoscopy over a four year period were retrospectively analysed. Indications for laparoscopy, morbidity, and reasons for conversion were investigated and predictors of morbidity and conversion were sought...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876603/the-role-of-laparoscopy-in-blunt-abdominal-trauma-diagnostic-therapeutic-or-both
#16
F Mosai
BACKGROUND: The use of laparoscopy in blunt abdominal trauma is gaining popularity as a useful diagnostic tool to avoid unnecessary laparotomies where there is diagnostic dilemma. But the feasibility of using laparoscopy for therapeutic intervention in these patients has been debated. Even though recent case reports seem to suggest that these patients can be managed using laparoscopy, the practice is not yet wildly adopted. METHOD: A retrospective analysis of a prospectively collected data was done...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28865527/emergency-computed-tomography-angiogram-of-the-chest-abdomen-and-pelvis
#17
Kimberly Weatherspoon, Wayne Gilbertie, Tara Catanzano
In the setting of blunt trauma, the rapid assessment of internal injuries is essential to prevent potentially fatal outcomes. Computed tomography is a useful diagnostic tool for both screening and diagnosis. In addition to trauma, acute chest syndromes often warrant emergent computed tomographic angiography, looking for etiologies such as aortic aneurysms or complications of aortic aneurysms, or both, pulmonary emboli, as well as other acute vascular process like aortic dissection and Takayasu aortitis. With continued improvements in diagnostic imaging, computed tomographic angiography of the chest, abdominal and pelvis proves to be an effective modality to image the aorta and other major vascular structures...
August 2017: Seminars in Ultrasound, CT, and MR
https://www.readbyqxmd.com/read/28865393/pediatric-aortoiliac-injury-following-blunt-abdominal-trauma-a-case-report
#18
Edward Daniele, Alan Coleman, Ben Hirsch, Thomas McGill, John Fitzwater
INTRODUCTION: The most common mechanism of aortic injury involves motor vehicle collisions resulting in aortic disruptions, occurring almost exclusively in the chest. Injury to the abdominal aorta following blunt trauma is nearly twenty times less likely to occur than the thoracic aorta. Because of the low incidence, there are few reports regarding the presentation and repair of these particular injuries, especially in the pediatric population. PRESENTATION OF CASE: We present a case of a 7-year-old boy involved in a high speed motor vehicle accident with an abdominal aorta transection at the aortic bifurcation extending into the left iliac artery...
July 20, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28855777/characteristics-and-management-of-blunt-renal-injury-in-children
#19
Yuichi Ishida, Alan H Tyroch, Nader Emami, Susan F McLean
BACKGROUND: Renal trauma in the pediatric population is predominately due to blunt mechanism of injury. Our purpose was to determine the associated injuries, features, incidence, management, and outcomes of kidney injuries resulting from blunt trauma in the pediatric population in a single level I trauma center. METHODS: This was a retrospective chart and trauma registry review of all pediatric blunt renal injuries at a regional level I trauma center that provides care to injured adults and children...
July 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28852464/missed-diagnosis-of-a-large-right-sided-diaphragmatic-rupture-with-herniated-liver-and-concomitant-liver-laceration-after-blunt-trauma-consequences-for-delayed-surgical-repair
#20
Kjetil Søreide, Andreas Reite, Rune Haaverstad
Diaphragmatic injuries are relatively rare and as such frequently missed, particularly if they occur as a rare event on the right-sided dome. Even if detected in the early phase, the concomitant injury of other organs may delay the time to repair. The delay in surgical correction may aggravate additional adherences between thoracic and abdominal organs and cause the diaphragmatic muscle to retract, causing a larger tissue defect that may prevent primary suture repair. This should be taken into consideration when choosing access to repair (thoracic, abdominal or both cavities), mode (open or laparoscopic) and type of repair (primary suture or use of mesh material to close the defect)...
August 2017: Journal of Surgical Case Reports
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