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trauma abdominal in adults

Laura Montoya-Sánchez, Rocío Del P Pereira-Ospina, Javier Y Pinzón-Salamanca, José M Suescún-Vargas
Pancreatitis consists in acute inflammation of the pancreas that is clinically characterized by abdominal pain. To make the diagnosis it is necessary the elevation of biochemical markers like pancreatic amylase or lipase. It is the most frequent pancreatic disease in both children and adults. Its presentation in the pediatric population is increasing and has several etiologies such as: infections, trauma, intoxication and metabolic diseases. Trauma mechanisms have been described: child maltreatment, falls, trauma with the bicycle handle and traffic accidents...
April 1, 2018: Archivos Argentinos de Pediatría
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
Yang Li, Wei-Guang Li, Ze-Guo Feng, Cheng-Gang Zhang, Lian-Jun Huang, Xiao-Rui Yang, Ying-Qun Yu
OBJECTIVE: To investigate the effect of propofol and operative trauma on the neurodevelopment and cognitive function of the developing brain and its mechanism. METHODS: A total of 104 postnatal day 13 Sprague-Dawley rats were randomly divided into 4 groups: control group (treated by 7.5 mL/kg saline and sham surgery), propofol group (treated by 75 mg/kg propofol), surgery group (with abdominal surgery under local anesthesia) and propofol+surgery group (with abdominal surgery under local anesthesia plus 75 mg/kg propofol anesthesia)...
February 20, 2018: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Selman Yeniocak, Asım Kalkan, Ozgur Sogut, Gökce Akgül Karadana, Mehmet Toptas
Objective: Since the homeless are at greater risk of encountering health problems than the general population, the reasons for and incidence of their presentations to emergency departments also vary. The purpose of this study was to determine the sociodemographic and clinical characteristics of Turkish homeless patients who brought to the emergency department by ambulance. Materials and methods: The records of homeless adult patients brought to the ED by 112 emergency service ambulance teams over a 1-year period from January to December, 2014, were examined retrospectively...
December 2017: Turkish Journal of Emergency Medicine
T Chan, M S Bleszynski, D S Youssef, M Segedi, S Chung, C H Scudamore, A K Buczkowski
INTRODUCTION: Damage control laparotomy with vacuum assisted closure (VAC) is used for selective cases in trauma. In liver transplantation, VAC has also been applied for management of intra-operative hemorrhage. The primary objective was to evaluate peri-operative blood loss and blood product utilization in VAC compared to primary abdominal closure (PAC) at the index transplant operation. METHODS: Retrospective review of all adults undergoing deceased donor liver transplantation (2007-2011) at a single center tertiary care institution...
January 31, 2018: American Journal of Surgery
A David Rothner
Migraine in children can manifest in ways that are markedly different from adult migraines. In children, migraine variants are often unaccompanied by headache and include conditions such as cyclic vomiting and abdominal migraine. Children who experience these conditions are often thought to have a disorder of the gastrointestinal tract, and when evaluation is unremarkable they may be diagnosed as having a conversion reaction. Complicated migraines, on the other hand, are often accompanied by focal neurological symptoms such as ataxia, hemiparesis, or altered level of consciousness that evoke great consternation in the examining clinician...
February 1, 2018: Pediatric Annals
J Waskowski, J C Schefold, F Stueber
BACKGROUND: Minimising perioperative bleeding is a key goal of "patient blood management" programs. One component of respective strategies includes preventive inhibition of fibrinolysis using protease inhibitors, such as tranexamic acid (TXA). TXA inhibits plasminogen activation and plasmin-induced fibrin degradation. OBJECTIVES: The present article provides an overview of the existing literature and TXA applications in the prophylaxis of perioperative bleeding...
January 24, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
L Tallón-Aguilar, J A López-Ruiz, C Domínguez-Sánchez, F Pareja-Ciuró, J Padillo-Ruiz
Chylous ascites is a rare condition little reported in literature, with even more exceptional traumatic origin. Its production mechanism is not known exactly but has been attributed to hyperflexion or hyperextension of the spine leading to a rupture of lymph ducts. We present a case of post-traumatic chyloperitoneum in a young patient after abdominal blunt trauma. Conservative treatment should be the first therapeutic option, especially if the origin is traumatic, reserving more aggressive possibilities for cases that do not respond after 15 days, if debt is greater than 1...
January 24, 2018: Annals of the Royal College of Surgeons of England
C E M Pothmann, K Sprengel, H Alkadhi, G Osterhoff, F Allemann, T Jentzsch, G Jukema, H C Pape, H-P Simmen, V Neuhaus
Abdominal injuries are potentially life-threatening and occur in 20-25% of all polytraumatized patients. Blunt trauma is the main mechanism. The liver and spleen are most commonly injured and much less often the intestines. The clinical evaluation proves equivocal in many cases; therefore, the gold standard is computed tomography (CT), which has been increasingly used even in hemodynamically weakly stable or sometimes even unstable patients because it promptly provides precise diagnostic findings, which present the basis for successful therapy...
January 19, 2018: Der Unfallchirurg
Suzan Gunduz, Semra Kara, Ayşe Aktas, Abdulkadir Eren, Vedat Bakan
Macrosomia is a risk factor for birth injuries and is associated with neonatal morbidity and mortality. Cephalohematoma and clavicular fracture are the most frequent birth injuries. Intraabdominal injuries are uncommon birth injuries. Rectus sheath hematoma (RSH) is an accumulation of blood in the sheath of rectus abdominis muscle. It is associated with trauma, operations and anticoagulant therapy, especially in adults and elders. We present a macrosomic male neonate with difficult vaginal delivery, who had in the physical examination periumblical ecchymose of 1x1 cm and a parietal cephalohametoma of 1x1 cm...
February 1, 2018: Archivos Argentinos de Pediatría
Christopher Harmston, James Benjamin Marsden Ward, Abhilasha Patel
INTRODUCTION: Hollow viscus injury (HVI) due to blunt abdominal trauma remains a diagnostic challenge, often presenting late and results in delayed intervention. Despite several treatment algorithms, there is currently no consensus on how to manage patients with HVI. The aim of this review was to define clinical outcomes and the effect of delayed intervention in patients with HVI due to blunt abdominal trauma. The primary outcome of interest was difference in mortality between groups...
January 4, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Eline Chauvet, Vasiliki Spyropoulou, Mehrak Anooshiravani-Dumont, Oliver Sanchez, Laurence Lacroix
Accessory spleen rupture may occur after blunt abdominal trauma or, more rarely, spontaneously. Although only few cases are described in adults, it is even more uncommon in children. We report the case of a 13-year-old boy with traumatic accessory spleen fracture. After a review of the literature, we discuss the diagnostic points that should raise the suspicion for accessory spleen fracture as well as how challenging the diagnosis by computed tomography can be.
January 2, 2018: Pediatric Emergency Care
Cedric Benson, Janice Weinberg, Chaitan K Narsule, Tejal S Brahmbhatt
BACKGROUND: The effect of alcohol exposure on patients undergoing a laparotomy for trauma is unknown. The purpose of this study was to compare outcomes of morbidity and mortality between alcohol positive and alcohol negative trauma patients who required emergent laparotomies using the National Trauma Data Bank (NTDB). METHODS: A retrospective database analysis was performed using 28,354 NTDB incident trauma cases, from 2007 through 2012, who had been tested for alcohol and who required abdominal operations (using ICD-9-CM procedure codes) within 24h of presentation...
November 13, 2017: American Journal of Emergency Medicine
Stefania Cimbanassi, Osvaldo Chiara, Ari Leppaniemi, Sharon Henry, Thomas M Scalea, Kathirkamanathan Shanmuganathan, Walter Biffl, Fausto Catena, Luca Ansaloni, Gregorio Tugnoli, Elvio De Blasio, Arturo Chieregato, Giovanni Gordini, Sergio Ribaldi, Maurizio Castriconi, Patrizio Festa, Federico Coccolini, Salomone di Saverio, Antonio Galfano, Massimo Massi, Marilena Celano, Massimiliano Mutignani, Stefano Rausei, Desiree Pantalone, Antonio Rampoldi, Luca Fattori, Stefano Miniello, Sebastian Sgardello, Francesca Bindi, Federica Renzi, Fabrizio Sammartano
No abstract text is available yet for this article.
March 2018: Journal of Trauma and Acute Care Surgery
Christopher Dang, Eitan Dickman, Mark O Tessaro, Pranjal Patel, Maxim Dzeba, Antonios Likourezos, Illya Pushkar, Peter Homel, Lawrence E Haines
OBJECTIVE: Emergency Department patients with abdominal pain may require both an ultrasound (US) and computed tomography (CT) for an accurate diagnosis. Patients are often asked to drink oral radiocontrast while awaiting ultrasound, in order to better expedite a CT in the case of a non-diagnostic US. The impact of oral radiocontrast on US image quality has not been studied. We compared the quality of US images obtained before and after the ingestion of oral radiocontrast in healthy adult volunteers...
November 20, 2017: American Journal of Emergency Medicine
Hanish Kataria, Vinod Prem Singh
Adhesion formation after abdominal and pelvic operations remains a challenging problem. Role of adjuvant barriers have been studied but there is no comparative study between liquid paraffin and hyaluronic acid as a barrier method. Hence, we planned to compare the effectiveness of 0.4 % hyaluronic acid and liquid paraffin in the prevention of postoperative intraperitoneal adhesions in rats. This prospective, randomized and controlled study was conducted in 60 adult Wistar albino rats. Surgical trauma by caecal abrasion and 1 g talcum powder was used in the rat model to induce adhesion formation...
December 2017: Indian Journal of Surgery
Haldun Akoglu, Omer Faruk Celik, Ali Celik, Rabia Ergelen, Ozge Onur, Arzu Denizbasi
INTRODUCTION: The diagnostic accuracy of the FAST exam performed by EM residents were shown to be similar to radiology residents. However, in the last 2 decades, an extended-FAST (E-FAST) protocol including thoracic examination to exclude pneumo- and hemothorax was introduced. The accuracy of emergency physicians (EPs) while performing E-FAST is a less studied area, especially in Europe. The aim of this study was to compare the diagnostic accuracy of the E-FAST exam performed by EM residents with the results of CT scan as a gold standard...
November 8, 2017: American Journal of Emergency Medicine
Krishna K Varadhan, Dumitru Constantin-Teodosiu, Despina Constantin, Paul L Greenhaff, Dileep N Lobo
BACKGROUND & AIMS: Postoperative hyperglycaemia is common in patients having major surgery and is associated with adverse outcomes. This study aimed to determine whether bacteraemia contributed to postoperative systemic inflammation, and whether increases in the expression of muscle mRNAs and proteins reflecting increased muscle inflammation, atrophy and impaired carbohydrate oxidation were evident at the time of surgery, and both local and distant to the site of trauma, and could be associated with impaired glucoregulation...
November 2, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Christine K Fox, Nancy K Hills, David R Vinson, Adam L Numis, Rochelle A Dicker, Stephen Sidney, Heather J Fullerton
OBJECTIVE: To quantify the incidence, timing, and risk of ischemic stroke after trauma in a population-based young cohort. METHODS: We electronically identified trauma patients (<50 years old) from a population enrolled in a Northern Californian integrated health care delivery system (1997-2011). Within this cohort, we identified cases of arterial ischemic stroke within 4 weeks of trauma and 3 controls per case. A physician panel reviewed medical records, confirmed cases, and adjudicated whether the stroke was related to trauma...
December 5, 2017: Neurology
Matthew C Hernandez, Nadeem N Haddad, Daniel C Cullinane, D Dante Yeh, Salina Wydo, Kenji Inaba, Therese M Duane, Andrea Pakula, Ruby Skinner, Carlos J Rodriguez, Julie Dunn, Valerie G Sams, Martin D Zielinski, Asad Choudhry, David Turay, Ji-Ming Yune, Jill Watras, Kenneth A Widom, John Cull, Eric A Toschlog, John C Graybill
BACKGROUND: The American Association for the Surgery of Trauma (AAST) anatomic severity grading system for adhesive small bowel obstruction (ASBO) was validated at a single institution. We aimed to externally validate the AAST ASBO grading system using the Eastern Association for the Surgery of Trauma multi-institutional small bowel obstruction prospective observational study. METHODS: Adults (age ≥ 18) with (ASBO) were included. Baseline demographics, physiologic parameters (heart rate, blood pressure, respiratory rate), laboratory tests (lactate, hemoglobin, creatinine, leukocytosis), imaging findings, operative details, length of stay, and Clavien-Dindo complications were collected...
February 2018: Journal of Trauma and Acute Care Surgery
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