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liver laceration

Olubukunola Adesanya, Mubariz Naqvi
We report a rare, but serious, complication of a malpositioned umbilical venous catheter in a term male infant who developed laceration, hematoma, and necrosis of liver, ascites, and left-sided obstructive uropathy secondary to extravasation of total parenteral nutrition. Abdominal paracentesis confirmed the presence of parenteral nutrition in the peritoneal cavity. Although, the umbilical venous catheterization is a common intravenous access used in neonatal intensive care units, judicious continued monitoring of its use should be practiced to avoid serious complications...
2016: Global Pediatric Health
Chad G Ball, Andre Campbell, Sean C Grondin, Elijah Dixon
INTRODUCTION: Ongoing hemorrhage is often life threatening and can be challenging to stop in critically injured patients. Traditional techniques for addressing this issue include high voltage cautery (Bovie), topical hemostatic application, and the delivery of ignited argon gas. The goal of this study was to evaluate the efficacy of a novel energy device for arresting ongoing bleeding from both solid and non-solid organs within a swine model. METHODS: A novel instrument utilizing bipolar radiofrequency (RF) energy which acts to ignite/boil dripping saline from a small hand piece was employed to arrest ongoing hemorrhage from an escalating series of injuries in large male swine...
September 30, 2016: Injury
Jesús A Bahena-Aponte, Guillermo Ramírez de Aguilar, Juan Carlos Torres Carrillo, Luis Espino Urbina, Jesús A Sánchez González
We present the case of a 34 years old female patient who presents with abdominal pain and elevated total and direct bilirrubins, so she underwent ERCP Reporting: a) successful sphincterotomy without complications, b) choledocholithias is endoscopically resolved, c) secondary cholangitis. She developed significant abdominal pain at 72 h, with hypovolemic shock and peritoneal irritation. She was taken to the surgery, finding a grade III liver laceration. This one was resolved with liver raffia and packing, during the same operative time cholecystectomy was performed...
July 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Guofeng Xu, Lei He, Xiaoliang Fang, Dapeng Jiang, Longhu Jin, Houwei Lin, Maosheng Xu, Yeming Wu, Hongquan Geng
We report two successful treatment cases of renal artery occlusion (RAO) related to multiple trauma. A 4-year-old boy was diagnosed with right RAO and liver laceration after a traffic accident. Surgical thrombectomy and revascularization were performed, but lacerated liver not sutured. Lacerated liver was surgical repaired 6 days postoperation because of delayed bleeding. 13% of the patient's right kidney function was conserved. Another 7-year-old boy was compressed by an agitator. Renal scintigraphy showed that the right kidney was nonfunctional...
September 7, 2016: Urology
Reza Safaeian, Valiollah Hassani, Hamid Reza Faiz
BACKGROUND Diaphragmatic rupture can be seen in up to 5% of car accidents, and 80%-100% of diaphragmatic hernias are associated with other vital organ injuries. Brain, pelvis, long bones, liver, spleen, and aorta are some other organs that can be severely damaged and need different anesthetic managements. CASE REPORT A 37-year-old male victim of a head-on collision who was suffering diaphragmatic rupture and corneal laceration was prepared for an emergency operation 11 hours after the car accident. Gastric decompression, pre-oxygenation, rapid sequence induction with succinylcholine, immediate use of non-depolarizing muscle relaxant, and mechanical ventilation with low tidal volume after intubation were used in anesthetic management of the patient...
2016: American Journal of Case Reports
Hee Ho Chu, Nam-Joon Yi, Hyo-Cheol Kim, Kwang-Woong Lee, Kyung-Suk Suh, Hwan Jun Jae, Jin Wook Chung
The purpose of this study was to evaluate the long-term outcomes of stent placement for a hepatic venous outflow obstruction in adult liver transplantation recipients. From June 2002 to March 2014, 23 patients were confirmed to have a hepatic venous outflow obstruction after liver transplantation (18 of 789 living donors [2.3%] and 5 of 449 deceased donors [1.1%]) at our institute. Among these patients, 16 stenotic lesions in 15 patients (12 males, 3 females; mean age: 51.7 years) underwent stent placement...
August 12, 2016: Liver Transplantation
Colin Cryer, Ted R Miller, Ronan A Lyons, Alison K Macpherson, Katherine Pérez, Eleni Th Petridou, Nick Dessypris, Gabrielle S Davie, Pauline J Gulliver, Jens Lauritsen, Soufiane Boufous, Bruce Lawrence, Brandon de Graaf, Claudia A Steiner
BACKGROUND: Governments wish to compare their performance in preventing serious injury. International comparisons based on hospital inpatient records are typically contaminated by variations in health services utilisation. To reduce these effects, a serious injury case definition has been proposed based on diagnoses with a high probability of inpatient admission (PrA). The aim of this paper was to identify diagnoses with estimated high PrA for selected developed countries. METHODS: The study population was injured persons of all ages who attended emergency department (ED) for their injury in regions of Canada, Denmark, Greece, Spain and the USA...
August 8, 2016: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
Yusuke Takahashi, Naoyuki Yokoyama, Natsumi Matsuzawa, Daisuke Sato, Tetsuya Otani
INTRODUCTION: Bile duct injury during laparoscopic cholecystectomy occurs in rare cases. We report two cases using barbed suture for repair in bile duct injury during laparoscopic cholecystectomies. PRESENTATION OF CASES: The first patient was a 73-year-old woman who underwent elective laparoscopic cholecystectomy for cholecystolithiasis. When the gallbladder was dissected from the bed, bile spillage was observed and an injured small bile duct was detected. The bile duct could not be managed using a titanium clip...
2016: International Journal of Surgery Case Reports
L Ressel, U Hetzel, E Ricci
Veterinary pathologists commonly encounter lesions of blunt trauma. The development of lesions is affected by the object's mass, velocity, size, shape, and angle of impact and by the plasticity and mobility of the impacted organ. Scrape, impact, and pattern abrasions cause localized epidermal loss and sometimes broken hairs and implanted foreign material. Contusions are best identified after reflecting the skin, and must be differentiated from coagulopathies and livor mortis. Lacerations-traumatic tissue tears-may have irregular margins, bridging by more resilient tissue, deviation of the wound tail, crushed hairs, and unilateral abrasion...
September 2016: Veterinary Pathology
E L G Pryzdial, S C Meixner, K Talbot, L J Eltringham-Smith, J R Baylis, F M H Lee, C J Kastrup, W P Sheffield
UNLABELLED: Essentials Factor Xa (FXa) acquires cleavage-mediated tissue plasminogen activator (tPA) cofactor activity. Recombinant (r) tPA is the predominant thrombolytic drug, but it may cause systemic side effects. Chemically modified, non-enzymatic FXa was produced (Xai-K), which rapidly lysed thrombi in mice. Unlike rtPA, Xai-K had no systemic fibrinolysis activation markers, indicating improved safety. SUMMARY: Background Enzymatic thrombolysis carries the risk of hemorrhage and re-occlusion must be evaded by co-administration with an anticoagulant...
September 2016: Journal of Thrombosis and Haemostasis: JTH
Sunhawit Junrungsee, Krongporn Ongprasert, Wasana Ko-Iam, Worakitti Lapisatepun, Tidarat Jirapongcharoenlap, Settapong Boonsri, Suraphong Lorsomradee, Anon Chotirosniramit, Trichak Sandhu
Donor scarcity is a primary problem in the development of a transplant program. The imbalance between an extremely increasing demand and the number of organs in the supply has led to an extended criteria donor approach. The successful use of donors with infectious diseases and septic shock has been reported. However, organs from deceased donors with traumatic abdominal injury and open abdomen are usually discarded due to risks of severe infections. Thus far, only 1 such case, in which a liver graft from an open abdomen was used successfully, has been reported...
May 17, 2016: Experimental and Clinical Transplantation
K Horst, D Eschbach, R Pfeifer, B Relja, M Sassen, T Steinfeldt, H Wulf, N Vogt, M Frink, S Ruchholtz, H C Pape, F Hildebrand
BACKGROUND: Hypothermia has been discussed as playing a role in improving the early phase of systemic inflammation. However, information on the impact of hypothermia on the local inflammatory response is sparse. We therefore investigated the kinetics of local and systemic inflammation in the late posttraumatic phase after induction of hypothermia in an established porcine long-term model of combined trauma. MATERIALS & METHODS: Male pigs (35 ± 5kg) were mechanically ventilated and monitored over the study period of 48 h...
2016: PloS One
Edward Daniele, Sharmila Dissanaike
INTRODUCTION: Advances in diagnostic imaging and monitoring have led to a shift towards primary non-operative management for most blunt liver injuries. Hemostatic biologic agents are a potential adjunct in the treatment of bile leak, especially in patients requiring surgery for drainage of a biloma. PRESENTATION OF CASE: We present a 31year old woman who presented to the hospital after a motor vehicle accident. She was found to have a Grade 4 liver injury causing hemoperitoneum...
2016: International Journal of Surgery Case Reports
Fröhlich Matthias, Marc Maegele, Frank Hildebrand, Matthias Weuster, Philipp Mommsen, Juliane Mohr, Ingo Witte, Roman Pfeifer, Georg Feichtinger, Claudia Keibl, Sascha Flohé, Martijn van Griensven
INTRODUCTION: Multiple organ dysfunction syndrome (MODS) and the resulting multiple organ failure (MOF) following severe trauma are associated with increased morbidity and mortality. Due to intestinal mucosal lesions and gut barrier disorders, the intestine contributes decisively to how post-traumatic MOF develops. As mild therapeutic hypothermia has been found to have protective effects on post-traumatic organ injuries, we analysed its effects on the intestine. METHODS: In a porcine model, Forty pigs were assigned to four groups: sham or trauma groups each with two sub-groups receiving either hypothermia or normothermia...
April 6, 2016: Shock
Halil Beydilli, Yasemin Balcı, Şahin Işık, Melike Erbaş, Ethem Acar, Bülent Savran
BACKGROUND: The purpose of this study was to determine complications of resuscitation seen during autopsies and evaluate the effectiveness of basic life support training. METHODS: Autopsy case reports conducted in The Forensic Branch Manager of Muğla were retrospectively examined. Demographic data of the patients with resuscitation complications such as age, gender, manner of death, and kinds and features of the complications were recorded. RESULTS: In total, seventy-fourof the 100 cases with resuscitation complications were males...
December 2015: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Chad G Ball, Andre Campbell, Sean C Grondin, Elijah Dixon, Joseph DuBose, Paul B McBeth, Rohan Lall
INTRODUCTION: Solid organ (liver, spleen and kidney) haemorrhage is often life threatening and can be difficult to stop in critically ill patients. Traditional techniques for arresting this ongoing bleeding include coagulation by high voltage cautery (Bovie), topical haemostatic application, and the delivery of ignited argon gas. The goal of this study was to evaluate the efficacy of a new energy device for arresting persistent solid organ haemorrhage. PATIENTS AND METHODS: A novel instrument utilizing bipolar radiofrequency (RF) energy which acts to ignite/boil dripping saline from a simple hand piece was employed to arrest ongoing bleeding from solid organ injuries at 2 high volume, level 1 trauma centres...
September 2016: Injury
Alexander Gombert, Mohammad Esmaeil Barbati, Jochen Grommes, Houman Jalaie, Karina Schleimer, Michael J Jacobs, Johannes Kalder
BACKGROUND: Blunt thoracic aortic injuries (BTAIs) are rare but life threatening. Most BTAI are caused by high-energy trauma. Among children with blunt trauma, the incidence of BTAI is below 1 percent. The present case deals with covered thoracic aortic rupture of a 15-year-old boy. Emphasizing the value and the difficulties of endovascular surgery in children is the motivation for this case report. CASE REPORT: We are presenting the case of a 15-year-old boy, who suffered multiple traumata after accident...
May 2016: Annals of Vascular Surgery
Tutku Soyer, Fatih Andiran, Mithat Haliloglu, Feridun Cahit Tanyel
The case of an 11-year-old girl who developed acute abdomen after an accidental fall over an iron bar is reported to discuss the diagnostic features and treatment options for traumatic rupture of a choledochal cyst (CC) in children. The patient was admitted to the emergency department with complaints of vomiting and abdominal pain. Physical examination revealed tenderness at the right upper quadrant of the abdomen. Computed tomography findings revealed a rupture of a type IV CC and laceration of the liver. Cholecystectomy, total excision of the cyst, and hepaticojejunostomy were performed...
March 2016: Pediatric Emergency Care
Selman Uranues, Yusuf A Kilic
BACKGROUND: Intra-abdominal organs, most commonly the spleen and liver, are injured in 40-50% of polytraumatized patients. Because of its important immunological functions, preservation of the injured spleen is of paramount importance. METHODS: There are both conservative and surgical approaches to preservation of the spleen in trauma cases. Of the techniques available for this purpose, tissue adhesives, coagulation, partial resection, and mesh splenorrhapy are the most suitable...
August 2008: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Emir Hoti, Aisling Hogan, Chris Hegarty, Olga Tucker, Donal Maguire, Justin Geoghegan, Oscar Traynor
The liver is the most frequently injured intra-abdominal organ and is the main cause of death in patients with abdominal injuries (mortality 10-15%). Grades III and IV liver injuries may present a complex problem to the surgeon. Several techniques to prevent exsanguination have been described including perihepatic packing, hepatic artery ligation, liver suturing or resection, and hepatectomy with transplantation. We report a case of a trauma patient who underwent perihepatic packing to control bleeding. Following pack removal, the patient developed severe cardiorespiratory depression resulting from postreperfusion syndrome requiring emergency total hepatectomy and liver transplantation...
June 2008: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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