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https://www.readbyqxmd.com/read/27906869/early-and-sustained-vasopressin-infusion-augments-the-hemodynamic-efficacy-of-restrictive-fluid-resuscitation-and-improves-survival-in-a-liver-laceration-model-of-hemorrhagic-shock
#1
Raúl J Gazmuri, Kasen Whitehouse, Kruti Shah, Karla Whittinghill, Alvin Baetiong, Jeejabai Radhakrishnan
BACKGROUND: Current management of hemorrhagic shock favors restrictive fluid resuscitation before control of the bleeding source. We investigated the additional effects of early and sustained vasopressin infusion in a swine model of hemorrhagic shock produced by liver laceration. METHODS: Forty male domestic pigs (32 to 40 kg) had a liver laceration inflicted with an X-shaped blade clamp, 32 received a second laceration at minute 7.5, and 24 received two additional lacerations at minute 15...
November 30, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27896328/liver-laceration-related-to-cardiopulmonary-resuscitation
#2
Halil Beydilli, Yasemin Balci, Melike Erbas, Ethem Acar, Sahin Isik, Bulent Savran
Cardiopulmonary resuscitation (CPR) is recognized as a medical procedure performed to maintain vital functions of a person whose cardiac and respiratory functions have stopped. Chest compression is the most essential component of CPR and it is performed on the lower half of the sternum. During CPR, many complications may occur because of chest compressions, especially chest injuries including sternum and rib fractures. Rarely tracheal injury, rupture of the stomach, or liver or spleen injury may also occur as complications...
June 2016: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27854071/staged-laparotomies-based-on-the-damage-control-principle-to-treat-hemodynamically-unstable-grade-iv-blunt-hepatic-injury-in-an-eight-year-old-girl
#3
Takashi Kobayashi, Masayuki Kubota, Yuhki Arai, Toshiyuki Ohyama, Naoki Yokota, Kohei Miura, Hirosuke Ishikawa, Daiki Soma, Kazuyasu Takizawa, Jun Sakata, Masayuki Nagahashi, Hitoshi Kameyama, Toshifumi Wakai
BACKGROUND: Severe blunt hepatic injury is a major cause of morbidity and mortality in pediatric patients. Damage control (DC) surgery has been reported to be useful in severely compromised children with hepatic injury. We applied such a technique in the treatment of a case of hemodynamically unstable grade IV blunt hepatic injury in an eight-year-old girl. This case is the first to use multimodal approaches including perihepatic packing, temporary closure of the abdominal wall with a plastic sheet, transarterial embolization (TAE), and planned delayed anatomical hepatic resection in a child...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27807573/portal-hypertension-and-ascites-due-to-an-arterioportal-fistula-sequela-of-a-remote-traumatic-liver-laceration
#4
Benjamin M Hulkower, Sabah Butty, Marwan Ghabril
Arterioportal fistulas (APFs) are a group of vascular disorders, in which systemic arteries communicate with the portal circulation, presenting as a congenital syndrome or more commonly acquired from iatrogenic instrumentation or abdominal trauma. We report the case of a 58-year-old man who developed ascites without underlying risk factors for portal hypertension, which was attributed to an APF found on imaging, manifesting 43 years after sustaining a liver laceration. After angiographic embolization of the APF, the patient's ascites resolved completely...
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/27797450/s2-subsite-variations-between-human-and-mouse-enzymes-plasmin-factor-xia-kallikrein-elucidate-inhibition-differences-by-tfpi-2-domain1-wildtype-leu17arg-mutant-and-aprotinin
#5
K Vadivel, Y Kumar, G I Ogueli, S M Ponnuraj, P Wongkongkathep, J A Loo, M S Bajaj, S P Bajaj
BACKGROUND: Using TFPI-2 Kunitz domain1 (KD1), we obtained a bifunctional antifibrinolytic molecule (KD1L17R -KT ) with C-terminal lysine (kringle domain binding) and P2'-residue arginine (improved specificity towards plasmin). KD1L17R -KT strongly inhibited human plasmin (hPm), with no inhibition of human kallikrein (hKLK) or factor XIa (hXIa). Furthermore, KD1L17R -KT reduced blood loss comparable to aprotinin in a mouse liver-laceration model of organ hemorrhage. However, effectiveness of these antifibrinolytic agents in a model of hemorrhage mimicking extremity trauma and their inhibition efficiencies for mouse enzymes (mPm, mKLK or mXIa) remain to be determined...
October 31, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27766283/term-neonate-with-liver-laceration-obstructive-uropathy-and-ascites-secondary-to-extravasation-of-total-parenteral-nutrition-a-complication-of-malpositioned-umbilical-venous-catheter
#6
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
https://www.readbyqxmd.com/read/27717541/the-efficacy-of-a-novel-saline-bipolar-radiofrequency-energy-instrument-for-arresting-ongoing-solid-and-non-solid-organ-hemorrhage-in-a-swine-model
#7
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...
December 2016: Injury
https://www.readbyqxmd.com/read/27716762/-spontaneous-liver-rupture-in-a-patient-with-choledocholithiasis-resolved-by-ercp
#8
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
https://www.readbyqxmd.com/read/27614121/management-of-renal-artery-occlusion-related-to-multiple-trauma-in-children-two-case-reports
#9
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
https://www.readbyqxmd.com/read/27595907/anesthesia-for-traumatic-diaphragmatic-hernia-associated-with-corneal-laceration
#10
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
https://www.readbyqxmd.com/read/27516340/long-term-outcomes-of-stent-placement-for-hepatic-venous-outflow-obstruction-in-adult-liver-transplantation-recipients
#11
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
https://www.readbyqxmd.com/read/27501735/towards-valid-serious-non-fatal-injury-indicators-for-international-comparisons-based-on-probability-of-admission-estimates
#12
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
https://www.readbyqxmd.com/read/27497939/effectiveness-of-a-barbed-suture-in-the-repair-of-bile-duct-injury-during-laparoscopic-cholecystectomy-report-of-two-cases
#13
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
https://www.readbyqxmd.com/read/27381403/blunt-force-trauma-in-veterinary-forensic-pathology
#14
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
https://www.readbyqxmd.com/read/27359348/thrombolysis-by-chemically-modified-coagulation-factor-xa
#15
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
https://www.readbyqxmd.com/read/27211988/lacerated-liver-graft-in-an-open-abdomen-setting-a-case-report
#16
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
https://www.readbyqxmd.com/read/27144532/long-term-effects-of-induced-hypothermia-on-local-and-systemic-inflammation-results-from-a-porcine-long-term-trauma-model
#17
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
https://www.readbyqxmd.com/read/27085105/bioglue-for-traumatic-liver-laceration
#18
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
https://www.readbyqxmd.com/read/27058042/induced-hypothermia-preserves-the-functional-enterocyte-mass-in-a-porcine-multiple-trauma-model-retracted
#19
Matthias Fröhlich, 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...
May 24, 2016: Shock
https://www.readbyqxmd.com/read/27054637/resuscitation-complications-encountered-in-forensic-autopsy-cases-performed-in-mu%C3%A4-la-province
#20
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
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