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Blunt abdominal trauma

Fatma Yazici Yilmaz, Begum Aydogan Mathyk, Serhat Yildiz, Nefise Nazli Yenigul, Ceren Saglam
The purpose of this study was to compare postoperative pain and neuropathy after primary caesarean sections with either blunt or sharp fascial expansions. A total of 123 women undergoing primary caesarean sections were included in the study. The sharp group had 61 patients, and the blunt group had 62. In the sharp group, the fascia was incised sharply and extended using scissors. In blunt group, the fascia was bluntly opened by lateral finger-pulling. The primary outcome was postoperative pain. The long-term chronic pain scores were significantly lower in the blunt group during mobilisation (p = ...
March 21, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Richa Kalsi, Charles B Drucker, Jose H Salazar, Lauren I Luther, Jose J Diaz, Rishi Kundi
Blunt abdominal aortic injury is an infrequent occurrence after blunt trauma. The majority of these injuries result from deceleration forces sustained in motor vehicle collisions. Effects of these forces on the thoracic aorta are well described, but associated spinal compression or distraction can also lead to injury of the affixed abdominal aorta. We present a case of multifocal blunt thoracic and abdominal aortic injury with circumferential abdominal aortic dissection, resulting in aortoaortic intussusception associated with a thoracolumbar spinal injury...
March 2018: Journal of Vascular Surgery Cases and Innovative Techniques
Darnell J Brown, Kuo Jung G Lu, Kristina Chang, Jennifer Levin, John T Schulz, Jeremy Goverman
Background: Morel-Lavallee lesions (MLLs) are rare internal degloving injuries typically caused by blunt traumatic injuries and most commonly occur around the hips and in association with pelvic or acetabular fractures. MLL is often overlooked in the setting of poly-trauma; therefore, clinicians must maintain a high degree of suspicion and be familiar with the management of such injuries, especially in obese poly-trauma patients. Case presentation: We present a 30-year-old female pedestrian struck by a motor vehicle who sustained multiple long bone fractures, a mesenteric hematoma, and full-thickness abdominal skin friction burn which masked a significant underlying abdominal MLL...
2018: Burns and Trauma
John H Harris, William H Harris, Sanjay Jain, A Y Ferguson, David A Hill, Amy M Trahan
PURPOSE: CTA is routinely ordered on level II blunt thoraco-abdominally injured patients for assessment of injury to the thoracic aorta. The vast majority of such assessments are negative. The question being asked is, Does the accurate interpretation of the three mediastinal signs permit reliable determination of which patients need CTA for aortic assessment? The purpose of this investigation was to evaluate the role of three specifically selected mediastinal anatomic signs on the initial supine chest radiograph (CXR) of adult level II blunt thoraco-abdominally injured patients for the presence or absence of a mediastinal hematoma...
March 13, 2018: Emergency Radiology
Jeremy R Wortman, Jennifer W Uyeda, Urvi P Fulwadhva, Aaron D Sodickson
Computed tomography (CT) is key to the assessment of hemodynamically stable patients with blunt or penetrating trauma to the abdomen and pelvis. Dual-energy (DE) CT is a technology that allows acquisition of data at both high and low kilovolt peaks, allowing materials that have different x-ray absorption behaviors as a function of kilovolt peak (such as iodine) to be differentiated and quantified. DE CT has a variety of postprocessing applications that may be helpful in abdominal and pelvic trauma, including iodine-selective imaging, virtual monenergetic imaging, and virtual noncalcium imaging...
March 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Georgios Karaolanis, Dimitrios Moris, C Cameron McCoy, Diamantis I Tsilimigras, Sotirios Georgopoulos, Chris Bakoyiannis
The evaluation and management of patients with abdominal vascular trauma or injury requires immediate and effective decision-making in these unfavorable circumstances. The majority of these patients arrive at trauma centers in profound shock, secondary to massive blood loss, which is often unrelenting. Moreover, ischemia, compartment syndrome, thrombosis, and embolization may also be life threatening and require immediate intervention. To minimize the risk of these potentially lethal complications, early understanding of the disease process and emergent therapeutic intervention are necessary...
2018: Frontiers in Surgery
Mafalda Massara, Roberto Prunella, Pasquale Gerardi, Antonio Lillo, Giovanni De Caridi, Raffaele Serra, Stefano Notarstefano, Giovanni Impedovo
Abdominal aortic pseudoaneurysm is a rare but life-threatening condition that occurs due to penetrating or blunt trauma. Clinical manifestations are variable, and the time interval from the initial trauma to diagnosis is variable. A prompt diagnosis and an aggressive management approach are required to avoid catastrophic complications. Possible treatment options are open surgical repair, endovascular repair, pseudoanerysmal sac thrombosis induction through direct thrombin injection, and coil embolization. Here, we present the case of a 75-year-old man affected by an infrarenal abdominal aortic pseudoaneurysm presenting with abdominal and lumbar pain for 3 days, who was successfully treated with an endograft...
December 25, 2017: Annals of Vascular Diseases
René Fahrner, Falk Rauchfuss, Hubert Scheuerlein, Utz Settmacher
BACKGROUND: There are numerous causes of hepatic gas formation that range from serious pathologies to incidental findings, including mesenteric infarction, liver abscess, inflammatory bowel disease or minimally invasive hepatic interventions. CASE PRESENTATION: We report a case of a 50-year-old man who was admitted to the emergency room after a car accident. The clinical examination and further diagnostics revealed a craniocerebral injury with a fracture of the skull, concomitant soft tissue lesions and subarachnoidal bleeding...
March 2, 2018: BMC Surgery
Richard Tsai, Demetrios Raptis, Constantine Raptis, Vincent M Mellnick
Traumatic abdominal aortic injury (TAAI) is a severe complication of penetrating and blunt trauma with significant morbidity and mortality, particularly if diagnosis is delayed. In patients with life-threatening injuries, accurate and prompt diagnosis of TAAI can be made with computed tomography (CT). Once the diagnosis of TAAI is made, the radiologist should provide an accurate description of the aortic lesion and the extent of injury in order to guide management whether it be non-operative, open aortic repair, or endoluminal stent repair...
February 28, 2018: Abdominal Radiology
W Bekker, V Y Kong, G L Laing, J L Bruce, V Manchev, D L Clarke
Introduction This audit focused on patients who sustained enteric injury following blunt abdominal trauma. Methods Our prospectively maintained electronic registry was interrogated retrospectively, and all patients who had sustained blunt abdominal trauma between December 2011 and January 2016 were identified. Results Overall, 2,045 patients had sustained blunt abdominal trauma during the period under review. Seventy per cent were male. The median age was 28 years. Sixty patients (2.9%) sustained a small bowel injury (SBI)...
February 27, 2018: Annals of the Royal College of Surgeons of England
Heng-Fu Lin, Ying-Da Chen, Shyr-Chyr Chen
Laparoscopy has been used for the diagnosis and treatment for hemodynamically stable patients with penetrating abdominal trauma. This study evaluated whether diagnostic and therapeutic laparoscopy can be used as effectively in select patients with blunt abdominal trauma. All hemodynamically stable patients undergoing operations for blunt abdominal trauma over a 10-year period (2006-2015) at a tertiary medical center were included. Patients undergoing laparotomy were categorized as group A. Patients who underwent laparoscopy were categorized as group B...
2018: PloS One
Orith Waisbourd-Zinman, Amit Shah, Henry C Lin, Elizabeth B Rand
INTRODUCTION: Massive splenomegaly from portal hypertension (PHTN) in children raises the specter of splenic rupture; however, the incidence, etiology, and risk of rupture have not been studied, nor have existing practices to reduce risk. We therefore performed an international survey to describe the splenic rupture cases in PHTN and to describe the existing empirical practice among hepatologists. METHODS: A questionnaire was constructed to elicit cases of splenic rupture and collect hepatologists' common practices for prevention of splenic rupture...
March 2018: Journal of Pediatric Gastroenterology and Nutrition
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
BACKGROUND: 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 noncompressible region for analysis...
March 2018: Journal of Trauma and Acute Care Surgery
Ashok Kumar Sokhal, Gaurav Prakash, Durgesh Kumar Saini, Kawaljit Singh, Satyanarayan Sankhwar, Bhupendra Pal Singh
The Page kidney is a rare phenomenon. External renal parenchymal compression is the culprit. We report two cases of young males with flank pain, renal mass, and hypertension with history of blunt abdominal trauma. Initially, hypertension was controlled by angiotensin-converting enzyme (ACE) inhibitors but gradually became refractory to medical treatment. Laparoscopic nephrectomy was performed in both patients. We emphasize the Page kidney as a cause of hypertension in young patients, presenting with flank pain and renal mass with or without complications of hypertension...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
Oana Bulat, Cristian Bulat, Mihaela Blaj, Ioana Lupusoru, Viorel Scripcariu
BACKGROUND: Schewanella spp. is Gram-negative bacteria, saprophytes and rarely pathogenic. Initially isolated in 193, these belong to the marine environment; Schewanella (Pseudomonas) putrefaciens was found in water, soil and animal sources and produces hydrogen sulphide. Saccharomyces cerevisiae is the well-known yeast used for fermentation in industry and in molecular biology for research. In humans, it is a very rare pathogen which colonises the digestive tract and its utility has been linked to the treatment and prevention of diarrhoea associated with Clostridium difficile...
February 15, 2018: Balkan Medical Journal
Takahiro Shoji, Takehiko Tarui, Takashi Igarashi, Yuki Mochida, Hiroyuki Morinaga, Yasuhiko Miyakuni, Yoshitaka Inoue, Yasuhiko Kaita, Hiroshi Miyauchi, Yoshihiro Yamaguchi
BACKGROUND: Bleeding from hemorrhagic shock can be immediately controlled by blocking the proximal part of the hemorrhagic point using either resuscitative thoracotomy for aortic cross-clamping or insertion of a large-caliber (10-14Fr) resuscitative endovascular balloon occlusion of the aorta (REBOA) device via the femoral artery. However, such methods are very invasive and have various complications. With recent progress in endovascular treatment, a low-profile REBOA device (7Fr) has been developed...
February 10, 2018: Journal of Emergency Medicine
Mohamed Tarchouli, Mohamed Elabsi, Noureddine Njoumi, Mohamed Essarghini, Mahjoub Echarrab, Mohamed Rachid Chkoff
BACKGROUND: The liver is the most commonly damaged organ in abdominal trauma. The management of liver trauma has experienced many changes over the last two decades. Currently there is a trend toward a non-operative treatment warranted by the successful pediatric experience and better results recorded in many trauma centers worldwide. This study aimed to evaluate outcomes of operative and non-operative management of liver trauma in our institution over the last five years. METHODS: The patients with a diagnosis of blunt or penetrating liver injuries, admitted and managed in our hospital from January 2012 to December 2016 were retrospectively studied...
February 2018: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Narin Uludag, Anna Tötterman, Mats Beckman, Anders Sundin
OBJECTIVE: To assess the extent of pelvic hemorrhage on CT and to estimate its significance on outcome in patients with blunt high-energy pelvic trauma. METHODS: 576 patients with blunt high energy pelvic fractures in 2005-2011 were identified in the hospital's Trauma Registry (a major Trauma Center). 60 of these met our further inclusion criteria of initial systolic blood pressure ≤100 mmHg and pelvic-related hemorrhage. CT scans of the patients were reviewed with regard to pelvic and abdominal retroperitoneal hemorrhage, type of fracture (Tile classification) and associated injuries...
February 8, 2018: British Journal of Radiology
Sharfuddin Chowdhury, Andrew John Nicol, Mahammed Riyaad Moydien, Pradeep Harkison Navsaria, Luis Felipe Montoya-Pelaez
Background: The optimal timing for emergency surgical interventions and implementation of protocols for trauma surgery is insufficient in the literature. The Groote Schuur emergency surgery triage (GSEST) system, based on Cape Triaging Score (CTS), is followed at Groote Schuur Hospital (GSH) for triaging emergency surgical cases including trauma cases. The study aimed to look at the effect of delay in surgery after scheduling based on the GSEST system has an impact on outcome in terms of postoperative complications and death...
2018: World Journal of Emergency Surgery: WJES
Dennis Hundersmarck, Raechel J Toorop
No abstract text is available yet for this article.
February 3, 2018: European Journal of Vascular and Endovascular Surgery
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