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Blunt abdominal trauma

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https://www.readbyqxmd.com/read/28434082/senior-general-surgery-residents-can-be-trained-to-perform-focused-assessment-with-sonography-for-trauma-patients-accurately
#1
Sheng-Der Hsu, Cheng-Jueng Chen, De-Chuan Chan, Jyh-Cherng Yu
PURPOSES: Researchers studying trauma have found that physicians are able to perform a focused assessment with sonography for trauma (FAST) with minimal training and achieve ideal accuracy. However, there are currently no consensus or standard guidelines regarding the performance of this assessment. The aim of our study was to clarify the value of FAST performed by well-qualified senior general surgery residents in cases of suspected blunt abdominal trauma, which presents an important diagnostic problem in emergency departments...
April 22, 2017: Surgery Today
https://www.readbyqxmd.com/read/28433976/isolated-duodenal-rupture-primary-repair-without-diversion-is-it-safe-review-of-literature
#2
Muwaffaq Mezeil Telfah
Isolated duodenal rupture is a rare injury encountered among children following blunt abdominal trauma. Early diagnosis and treatment are essential to decrease the associated morbidity and mortality. The debate is about the optimum operative management. We report a 6-year-old child who presented with acute abdominal pain due to isolated duodenal injury following blunt abdominal trauma. Emergency laparotomy revealed duodenal rupture at the junction of the first and second part of duodenum and absence of any other visceral injuries...
April 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28431416/caring-for-critically-injured-children-an-analysis-of-56-pediatric-damage-control-laparotomies
#3
Miguel A Villalobos, Joshua P Hazelton, Rachel L Choron, Lisa Capano-Wehrle, Krystal Hunter, John P Gaughan, Steven E Ross, Mark J Seamon
BACKGROUND: Injury is the leading cause of death in children under 18 years. Damage control principles have been extensively studied in adults but remain relatively unstudied in children. Our primary study objective was to evaluate the use of damage control laparotomy (DCL) in critically injured children. METHODS: An American College of Surgeons-verified Level 1 trauma center review (1996-2013) of pediatric trauma laparotomies was undertaken. Exclusion criteria included: age older than 18 years, laparotomy for abdominal compartment syndrome or delayed longer than 2 hours after admission...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28427480/lessons-from-a-large-trauma-center-impact-of-blunt-chest-trauma-in-polytrauma-patients-still-a-relevant-problem
#4
REVIEW
Konstantina Chrysou, Gabriel Halat, Beatrix Hoksch, Ralph A Schmid, Gregor J Kocher
BACKGROUND: Thoracic trauma is the third most common cause of death after abdominal injury and head trauma in polytrauma patients. The purpose of this study was to investigate epidemiological data, treatment and outcome of polytrauma patients with blunt chest trauma in order to help improve management, prevent complications and decrease polytrauma patients' mortality. METHODS: In this retrospective study we included all polytrauma patients with blunt chest trauma admitted to our tertiary care center emergency department for a 2-year period, from June 2012 until May 2014...
April 20, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28424126/the-novel-use-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-to-explore-a-retroperitoneal-hematoma-in-a-hemodynamically-unstable-patient
#5
Martin D Rosenthal, Ahsan Raza, Stephanie Markle, Chasen A Croft, Alicia M Mohr, R Stephen Smith
Balloon occlusion of the aorta was first described by C.W. Hughes in 1954, when it was used as a tamponade device for three wounded soldiers during the Korean War suffering from intra-abdominal hemorrhage. Currently, the device is indicated in trauma patients as a surrogate for resuscitative thoracotomy. Brenner et al. reported a case series describing the use of resuscitative endovascular balloon occlusion of the aorta (REBOA) in advanced hemorrhagic shock. Their conclusion was that "it is a feasible method for proximal aortic control...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28403495/-diagnosis-and-therapeutic-management-in-kidney-ureter-and-bladder-trauma
#6
Karin Hirsch, Marco Heinz, Bernd Wullich
Trauma refers to the destruction of tissues or organs by external forces and it is the most common cause of mortality and morbidity in children (1, 2). Injuries of the genitourinary tract may be the result of blunt (falls, sport injuries, motor vehicle accidents and sexual abuse) or penetrating (stab wounds, gun shots, falling onto sharp objects) injuries. The genitourinary tract is significantly injured in 2.9% of paediatric trauma patients 4.In the paediatric population, the kidney is the most affected organ in the genitourinary tract (>60% of all genitourinary tract injuries) 4...
February 2017: Aktuelle Urologie
https://www.readbyqxmd.com/read/28399527/blunt-traumatic-extracranial-cerebrovascular-injury-and-ischemic-stroke
#7
Paul M Foreman, Mark R Harrigan
BACKGROUND: Ischemic stroke occurs in a significant subset of patients with blunt traumatic cerebrovascular injury (TCVI). The patients are victims of motor vehicle crashes, assaults or other high-energy collisions, and suffer ischemic stroke due to injury to the extracranial carotid or vertebral arteries. SUMMARY: An increasing number of patients with TCVI are being identified, largely because of the expanding use of computed tomography angiography for screening patients with blunt trauma...
April 11, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28382258/trends-in-nonoperative-management-of-traumatic-injuries-a-synopsis
#8
REVIEW
Stanislaw P A Stawicki
Nonoperative management of both blunt and penetrating injuries can be challenging. During the past three decades, there has been a major shift from operative to increasingly nonoperative management of traumatic injuries. Greater reliance on nonoperative, or "conservative" management of abdominal solid organ injuries is facilitated by the various sophisticated and highly accurate noninvasive imaging modalities at the trauma surgeon's disposal. This review discusses selected topics in nonoperative management of both blunt and penetrating trauma...
January 2017: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28382255/angioembolization-is-necessary-with-any-volume-of-contrast-extravasation-in-blunt-trauma
#9
Ankur Bhakta, David S Magee, Matthew S Peterson, Michael Shay O'Mara
INTRODUCTION: Reduction of nonessential angiogram and embolization for patients sustaining blunt abdominal and pelvic trauma would allow improved utilization and decreased morbidity related to nontherapeutic embolization. We hypothesized that the nature of intravenous contrast extravasation (IVCE) on computed tomography (CT) would be directly related to the finding of extravasation on angiogram and need for embolization. METHODS: A 5-year retrospective evaluation of trauma patients with IVCE on CT...
January 2017: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28376073/point-of-care-ultrasound-diagnosis-of-traumatic-abdominal-wall-hernia
#10
Lori B Bjork, Shawna D Bellew, Tobias Kummer
Traumatic abdominal wall hernias due to blunt abdominal trauma in pediatric patients can pose a diagnostic challenge because of spontaneous hernia reduction. Ultrasonography may be superior to computed tomography for this indication in some cases because of the ability to dynamically and repeatedly assess the area of injury. Herniation can be induced or exaggerated via Valsalva maneuvers, which can facilitate its detection during dynamic assessment. We present the case of a 3-year-old boy who sustained blunt abdominal trauma, with a resultant abdominal wall hernia that was diagnosed using point-of-care ultrasound imaging...
April 4, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28359296/motorbike-handlebar-hernia-a-rare-traumatic-abdominal-wall-hernia-a-case-report-and-review-of-the-literature
#11
Frank-Leonel Tianyi, Valirie Ndip Agbor, Tsi Njim
BACKGROUND: Handlebar hernias are very rare and arise following a sudden force from a handle-like object impacting a focal area of the abdomen, which results in a disruption of the underlying abdominal muscle and fascia without necessarily disrupting the overlying skin. Other than a reducible swelling on the abdominal wall, the physical examination of such patients is usually unremarkable and the diagnosis could easily be missed. CASE PRESENTATION: An 8-year-old Cameroonian boy with no significant past history presented to our emergency service with a tender left flank swelling following a road traffic accident...
March 31, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28351519/contrast-enhanced-ultrasound-for-the-evaluation-of-blunt-pediatric-abdominal-trauma
#12
Lindsey B Armstrong, David P Mooney, Harriet Paltiel, Carol Barnewolt, Beatrice Dionigi, Mary Arbuthnot, Chinwendu Onwubiko, Susan A Connolly, Delma Y Jarrett, Jill M Zalieckas
INTRODUCTION: Blunt abdominal trauma is a common problem in children. Computed tomography (CT) is the gold standard for imaging in pediatric blunt abdominal trauma, however up to 50% of CTs are normal and CT carries a risk of radiation-induced cancer. Contrast enhanced ultrasound (CEUS) may allow accurate detection of abdominal organ injuries while eliminating exposure to ionizing radiation. METHODS: Children aged 7-18years with a CT-diagnosed abdominal solid organ injury underwent grayscale/power Doppler ultrasound (conventional US) and CEUS within 48h of injury...
March 20, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28351473/accuracy-of-clinical-laboratory-and-computed-tomography-findings-for-identifying-hollow-viscus-injury-in-blunt-trauma-patients-with-unexplained-intraperitoneal-free-fluid-without-solid-organ-injury
#13
Evan Jost, Derek J Roberts, Todd Penney, Grant Brunet, Chad G Ball, Andrew W Kirkpatrick
BACKGROUND: We sought to define the accuracy of findings for detecting hollow viscus injury (HVI) in patients with blunt abdominal trauma (BAT) and unexplained intra-peritoneal free fluid without solid organ injury (UIPFFWSOI). METHODS: We screened all consecutive hemodynamically stable patients presenting to a quaternary-care trauma-centre who had an abdominal computed tomography (CT) scan for BAT and UIPFFWSOI (January 2007-December 2014). RESULTS: Of 3796 patients identified during the study period, 39 presented with UIPFFWSOI...
March 23, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28332921/leaving-the-skin-incision-open-may-not-be-as-beneficial-as-we-have-been-taught
#14
Jack C He, Brenda M Zosa, David Schechtman, Brian Brajcich, Jonathan C Savakus, Amanda L Wojahn, Derek Z Wang, Jeffrey A Claridge
BACKGROUND: Currently, various methods of skin closures are used in contaminated and dirty abdominal wounds without solid, evidence-based guidance. This study investigates whether closure methods affect surgical site infection (SSI) and other incisional complications. We hypothesize that open management of the skin would have the lowest complications, including SSI. PATIENTS AND METHODS: Patients age ≥18 who underwent trauma laparotomy (TL) or damage control laparotomy (DCL) from 2008-2013 and had class III/IV wounds were included...
March 23, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28303214/evidence-based-management-and-controversies-in-blunt-splenic-trauma
#15
REVIEW
D C Olthof, C H van der Vlies, J C Goslings
PURPOSE OF REVIEW: The study aims to describe the evidence-based management and controversies in blunt splenic trauma. RECENT FINDINGS: A shift from operative management to non-operative management (NOM) has occurred over the past decades where NOM has now become the standard of care in haemodynamically stable patients with blunt splenic injury. Splenic artery embolisation (SAE) is generally believed to increase the success rate of NOM. Not all the available evidence is that optimistic about SAE however...
2017: Current Trauma Reports
https://www.readbyqxmd.com/read/28302282/traumatic-pelvic-fractures-in-children-and-adolescents
#16
Christopher J DeFrancesco, Wudbhav N Sankar
Although traumatic pelvic fractures in children are relatively rare, these injuries are identified in about 5% of children admitted to level 1 trauma centers after blunt trauma.(1-4) Such injuries differ from adult pelvic fractures in important ways and require distinct strategies for management. While the associated mortality rate for children with pelvic fractures is much lower than that for adults, the patient may require urgent surgical intervention for associated life-threatening injuries such as head trauma and abdominal injury...
February 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28272851/the-effect-of-emergency-medical-services-response-on-outcome-of-trauma-laparotomy-at-a-level-1-trauma-centre-in-south-africa
#17
S Chowdhury, P H Navsaria, S Edu, A J Nicol
BACKGROUND: Due to resource constrained pre-hospital emergency medical services (EMSs) there is a significant delay in injured patients arriving at Groote Schuur Hospital Trauma Centre (GSHTC). The aim of the study was to examine the effectiveness of EMSs in transferring trauma patients to GSHTC. The effect of any delay to laparotomy from injury was noted. METHOD: A prospective audit of patients presented directly from the scene to GSHTC following abdominal trauma over a four-month period was performed...
November 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28261776/a-rare-cause-of-ileus-late-jejunal-stricture-following-blunt-abdominal-trauma
#18
Ulaş Aday, Ebubekir Gündeş, Kamuran Cumhur Değer, Hüseyin Çiyiltepe, Şükran Kayıpmaz, Mustafa Duman
Small intestinal stricture forming in the late phase following nonpenetrating abdominal trauma is rare cause of ileus. It has often been suggested that it is result of localized feeding deficiency on the intestinal wall related to minor trauma in the mesentery. Laparoscopy has been increasingly used for diagnosis and treatment. Diagnosis should be supported by pathological analyses in case of intestinal stenosis related to blunt abdominal traumas.
January 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28258447/time-to-ct-and-surgery-for-hpb-trauma-in-scotland-prior-to-the-introduction-of-major-trauma-centres
#19
P S McKechnie, D A Kerslake, R W Parks
AIMS: To assess the time taken to CT and emergency surgery for trauma patients with an injury to liver, spleen or pancreas prior to the introduction of major trauma centres (MTCs) in Scotland. METHODS: A search was performed of the Scottish Trauma Audit Group database for any patient with relevant injuries over a 2-year period. Primary outcome measures were time to CT and emergency surgery. Patient demographics were also recorded. RESULTS: A total of 211 patients were identified of whom 23 had more than one organ affected...
March 3, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28255580/clinical-applications-of-contrast-enhanced-ultrasound-in-the-pediatric-work-up-of-focal-liver-lesions-and-blunt-abdominal-trauma-a-systematic-review
#20
REVIEW
Nicolaj Grønbæk Laugesen, Christian Pallson Nolsoe, Jacob Rosenberg
In pediatrics ultrasound has long been viewed more favorably than imaging that exposes patients to radiation and iodinated contrast or requires sedation. It is child-friendly and diagnostic capabilities have been improved with the advent of contrast-enhanced ultrasound (CEUS). The application of CEUS is indeed promising. However, no ultrasound contrast agent manufactured today is registered for pediatric use in Europe. The contrast agent SonoVue(®) has recently been approved by the FDA under the name of Lumason(®) to be used in hepatic investigations in adults and children...
February 2017: Ultrasound International Open
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