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Pelvic hemorrhage

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https://www.readbyqxmd.com/read/27894498/noncompressible-torso-hemorrhage
#1
REVIEW
Jonathan J Morrison
Noncompressible torso hemorrhage (NCTH) constitutes a leading cause of potentially preventable trauma mortality. NCTH is defined by high-grade injury present in one or more of the following anatomic domains: pulmonary, solid abdominal organ, major vascular or pelvic trauma; plus hemodynamic instability or the need for immediate hemorrhage control. Rapid operative management, as part of a damage control resuscitation strategy, remains the mainstay of treatment. However, endovascular techniques are evolving and may become more mainstream with the advent of hybrid rooms that can deliver concurrent open and radiologic/endovascular management of traumatic hemorrhage...
January 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/27893645/preperitoneal-pelvic-packing-reduces-mortality-in-patients-with-life-threatening-hemorrhage-due-to-unstable-pelvic-fractures
#2
Clay Cothren Burlew, Ernest E Moore, Philip F Stahel, Andrea E Geddes, Amy E Wagenaar, Fredric M Pieracci, Charles J Fox, Eric M Campion, Jeffrey L Johnson, Cyril Mauffrey
BACKGROUND: A 2015 AAST trial reported a 32% mortality for pelvic fracture patients in shock. Angioembolization (AE) is the most common intervention; the Maryland group revealed time to AE averaged 5 hours. The goal of this study was to evaluate the time to intervention and outcomes of an alternative approach for pelvic hemorrhage. We hypothesized preperitoneal pelvic packing (PPP) results in a shorter time to intervention and lower mortality. METHODS: In 2004 we initiated a PPP protocol for pelvic fracture hemorrhage...
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27891285/complex-perineal-trauma-with-anorectal-avulsion
#3
Adelina Maria Cruceru, Ionut Negoi, Sorin Paun, Sorin Hostiuc, Ruxandra Irina Negoi, Mircea Beuran
Introduction. The objective of this case report is to illustrate a severe perineal impalement injury, associated with anorectal avulsion and hemorrhagic shock. Results. A 32-year-old male patient was referred to our hospital for an impalement perineal trauma, associated with complex pelvic fracture and massive perineal soft tissue destruction and anorectal avulsion. On arrival, the systolic blood pressure was 85 mm Hg and the hemoglobin was 7.1 g/dL. The patient was transported to the operating room, and perineal lavage, hemostasis, and repacking were performed...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27881610/primary-leiomyosarcoma-of-the-ovarian-vein-case-report-and-literature-review
#4
María Elena López-Ruiz, Laura Yébenes, Alberto Berjón, David Hardisson
Primary leiomyosarcoma arising from the ovarian vein is extremely rare, with only 10 cases reported in the literature. We report on a case of leiomyosarcoma of the left ovarian vein in a 67-year-old woman who presented with abdominal discomfort. Pelvic ultrasound revealed a large, solid, irregular mass in close relation to the left ovary. The patient subsequently underwent a total hysterectomy with bilateral salpingo-oophorectomy. Histologically, the tumor was composed of interlacing fascicles of spindle cells with abundant eosinophilic cytoplasm, hyperchromatic nuclei, and prominent nucleoli...
November 23, 2016: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/27876070/ovarian-thecoma-fibroma-groups-clinical-and-sonographic-features-with-pathological-comparison
#5
Hui Chen, Yan Liu, Li-Fei Shen, Mei-Jiao Jiang, Zhi-Fang Yang, Guo-Ping Fang
BACKGROUND: Ovarian thecoma-fibroma groups (OTFG) are uncommon sex cord-stromal neoplasms. The objective of the study was to demonstrate clinical and sonographic features of OTFG and compare with surgical histopathology. METHODS: A total of 61 patients with surgically proven OTFG were enrolled in this retrospective study to demonstrate its clinical and sonographic features and to compare with pathological findings. Gray scale and color Doppler sonography were performed presurgically with either transabdominal or transvaginal approach to image pelvic structures and lesions...
November 22, 2016: Journal of Ovarian Research
https://www.readbyqxmd.com/read/27865687/scoring-system-to-predict-hemorrhage-in-pelvic-ring-fracture
#6
T Ohmori, T Matsumoto, T Kitamura, R Tamura, K Tada, T Inoue, T Hayashi, K Numoto, T Tokioka
BACKGROUND: Risk factors for hemorrhage in patients with pelvic ring fracture have been widely reported. Because there are many risk factors, it is thought that prediction accuracy of hemorrhage in cases of pelvic ring fracture could be improved by using a scoring system. HYPOTHESIS: We investigated the risk factors for massive hemorrhage (MH) and created a novel predictive score of MH in pelvic ring fractures. MATERIAL AND METHODS: We retrospectively reviewed patients with pelvic ring fractures (Abbreviated Injury Score≥3 and age≥16 years) from January 2007 to June 2015...
December 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27863917/pelvic-fracture-in-multiple-trauma-a-67-case-series
#7
M Caillot, E Hammad, M Le Baron, V Villes, M Leone, X Flecher
INTRODUCTION: Severe pelvic trauma remains associated with elevated mortality, largely due to hemorrhagic shock. OBJECTIVE: The main study objective was to test for correlation between fracture type and mortality. The secondary objective was to assess the efficacy in terms of mortality of multidisciplinary management following a decision-tree in multiple trauma victims admitted to a level 1 trauma center. MATERIAL AND METHODS: Between July 2011 and July 2013, 534 severe trauma patients were included in a single-center continuous prospective observational study...
December 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27849473/high-fidelity-simulation-model-of-pelvic-hemorrhagic-trauma-the-future-for-military-surgical-skills-training
#8
David N Naumann, Douglas M Bowley, Mark J Midwinter, Alasdair Walker, Ian Pallister
No abstract text is available yet for this article.
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27847791/major-pelvic-bleeding-following-a-stapled-transanal-rectal-resection-use-of-laparoscopy-as-a-diagnostic-tool
#9
Giovanni Domenico Tebala, Abdul Qayyum Khan, Sean Keane
Stapled transanal rectal resection (STARR) and stapled hemorrhoidopexy (SH) are well-established techniques for treating rectal prolapse and obstructed defecation syndrome (ODS). Occasionally, they can be associated with severe complications. We describe the case of a 59-year-old woman who underwent STARR for ODS and developed a postoperative pelvic hemorrhage. A computed tomography (CT) scan revealed a vast pelvic, retroperitoneal hematoma and free gas in the abdomen. Laparoscopy ruled out any bowel lesions, but identified a hematoma of the pelvis...
October 2016: Annals of Coloproctology
https://www.readbyqxmd.com/read/27842662/in-bore-transrectal-mri-guided-prostate-biopsies-are-there-risk-factors-for-complications
#10
Michael Meier-Schroers, Rami Homsi, Guido Kukuk, Karsten Wolter, Georges Decker, Stefan Fischer, Christian Marx, Frederic Carsten Schmeel, Wolfgang Block, Alois Martin Sprinkart, Frank Traeber, Hans Heinz Schild, Winfried Willinek
PURPOSE: To systematically analyze risk factors for complications of in-bore transrectal MRI-guided prostate biopsies (MRGB). MATERIALS AND METHODS: 90 patients, who were scheduled for MRGB were included for this study. Exclusion criteria were coagulation disorders, therapy with anticoagulant drugs, and acute infections of the urinary and the lower gastrointestinal tract. Directly after, one week and one year after the biopsy, we assessed biopsy related complications (e...
December 2016: European Journal of Radiology
https://www.readbyqxmd.com/read/27836253/bi-manual-proximal-external-aortic-compression-after-major-abdominal-pelvic-trauma-and-during-ambulance-transfer-a-simulation-study
#11
M J Douma, D O'Dochartaigh, P G Brindley
BACKGROUND: Applying manual pressure after hemorrhage is intuitive, cost-free, and logistically-simple. When direct abdominal-pelvic compression fails, clinicians can attempt indirect proximal-external-aortic-compression (PEAC), while expediting transfer and definitive rescue. This study quantifies the sustainability of simulated bi-manual PEAC both immediately on scene and during subsequent ambulance transfer. The goal is to understand when bi-manual PEAC might be clinically-useful, and when to prioritize compression-devices or endovascular-occlusion...
November 5, 2016: Injury
https://www.readbyqxmd.com/read/27819791/-effectiveness-of-a-rapid-response-team-rrt-in-a-case-of-ruptured-ectopic-pregnancy
#12
José Miguel Campechano-López, María Lourdes Carranza-Bernal, Guillermina Juanico-Morales, María Rayo Reyes-Gil
BACKGROUND: An ectopic pregnancy happens when a fertilized egg attaches somewhere outside the endometrial surface. This sort of pregnancy has an estimated incidence of 1.6 to 2 each 100 births. The main objective was to expose the effective answer of a Rapid Response Team in a case of ruptured cervical ectopic pregnancy. We also describe a clinical case of this sort of pregnancy. CLINICAL CASE: 37-year-old female with a two-month history of amenorrhea. The patient entered the Labor & Delivery department with hypovolemic shock secondary to vaginal bleeding...
November 2016: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/27806534/association-between-adrenal-hematoma-and-mortality-in-pediatric-multiple-blunt-traumas-an-autopsy-evaluation
#13
Farrokh Taftachi, Leyla Abdolkarimi, Maryam Ameri, Azadeh Memarian, Alireza Behzadi, Hooman Bakhshandeh
Adrenal hematoma is a common hidden catastrophic complication in pediatric victims of multiple blunt traumas. Adrenal hematoma has no obvious symptoms and may not be detected by diagnostic methods such as magnetic resonance imaging, computed tomography scan, and sonography; consequently, this complication may be neglected in children with multiple blunt traumas and cause death through sudden adrenal crisis.The current study was conducted on 55 dead children (<13 y) and 110 matured youths (13-17 y) who died in consequence of multiple blunt traumas, comprising car crashes, fall from heights, and falling debris...
August 4, 2016: Global Journal of Health Science
https://www.readbyqxmd.com/read/27802006/carcinoma-prostate-masquerading-as-a-hemorrhagic-pelvic-cyst
#14
Rajat Arora, Arun Jacob Philip George, Anu Eapen, Antony Devasia
No abstract text is available yet for this article.
November 2, 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/27799653/-reboa-is-it-really-safe-a-case-with-massive-intracranial-hemorrhage-possibly-due-to-endovascular-balloon-occlusion-of-the-aorta-reboa
#15
Hayaki Uchino, Nobuichiro Tamura, Ryosuke Echigoya, Tetsunori Ikegami, Toshio Fukuoka
BACKGROUND Non-compressible torso hemorrhage continues to be the leading cause of preventable death in trauma patients. Recent case series report that resuscitative endovascular balloon occlusion of the aorta (REBOA) in the trauma population is a technically feasible method to manage the patients with exsanguinating hemorrhage. On the other hand, it seems that REBOA is being widely promoted prematurely. Complications due to REBOA haven't been reported much in the literature, and they could have been underestimated...
November 1, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27790349/diagnostic-accuracy-of-emergency-performed-focused-assessment-with-sonography-for-trauma-fast-in-blunt-abdominal-trauma
#16
Hamed Basir Ghafouri, Morteza Zare, Azam Bazrafshan, Ehsan Modirian, Shervin Farahmand, Niloofar Abazarian
INTRODUCTION: Intra-abdominal hemorrhage due to blunt abdominal trauma is a major cause of trauma-related mortality. Therefore, any action taken for facilitating the diagnosis of intra-abdominal hemorrhage could save the lives of patients more effectively. The aim of this study was to determine the accuracy of focused assessment with sonography for trauma (FAST) performed by emergency physicians. METHODS: In this cross-sectional study from February 2011 to January 2012 at 7(th) Tir Hospital in Tehran (Iran), 120 patients with abdominal blunt trauma were chosen and evaluated for abdominal fluid...
September 2016: Electronic Physician
https://www.readbyqxmd.com/read/27785900/can-coagulopathy-in-post-partum-hemorrhage-predict-maternal-morbidity
#17
Kyung Joon Oh, Joon-Seok Hong, Jina Youm, Soo-Hyun Cho, Eun Young Jung
AIM: The purpose of this study was to evaluate the clinical implications of coagulopathy in women with post-partum hemorrhage (PPH). METHODS: This retrospective cohort study included 262 consecutive women referred for management of PPH at a single tertiary hospital between 2009 and 2012. We reviewed medical records, including vital signs at arrival, laboratory values (hemoglobin, prothrombin time international normalized ratio [PT-INR], platelet, fibrinogen), and total amount of transfused blood product...
November 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27779598/clinical-significance-of-computed-tomography-contrast-extravasation-in-blunt-trauma-patients-with-a-pelvic-fracture
#18
Jeremy S Juern, David Milia, Panna Codner, Marshall Beckman, Lewis Somberg, Travis Webb, John A Weigelt
INTRODUCTION: Blunt pelvic fractures can be associated with major pelvic bleeding. The significance of contrast extravasation (CE) on computed tomography (CT) is debated. We sought to update our experience with CE on CT scan for the years 2009-2014 to determine the accuracy of CE in predicting the need for angioembolization. METHODS: This is a retrospective review of the trauma registry and our electronic medical record from a Level I trauma center. Patients seen from July 1, 2009 to September 7, 2014 with blunt pelvic fractures and contrast enhanced CT were included...
October 25, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27776896/transcatheter-arterial-embolization-with-ethylene-vinyl-alcohol-copolymer-onyx-for-the-treatment-of-hemorrhage-due-to-uterine-arteriovenous-malformations
#19
P-A Barral, M Saeed-Kilani, F Tradi, A Dabadie, J Izaaryene, J Soussan, J-M Bartoli, V Vidal
PURPOSE: The purpose of this study was to evaluate the effectiveness of ethylene vinyl alcohol copolymer (Onyx) as a single embolic agent for percutaneous arterial treatment of hemorrhage due to uterine arteriovenous malformations (AVMs). MATERIALS AND METHODS: Twelve women (mean age, 33 years) with metrorrhagia due to uterine AVMs who were treated by percutaneous arterial embolization using Onyx as a single embolic agent were retrospectively included. The diagnosis of uterine AVM was suggested by pelvic ultrasound and/or magnetic resonance imaging findings and further confirmed by angiography...
October 21, 2016: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/27760561/acute-transfusion-related-abdominal-injury-in-trauma-patients-a-case-report
#20
P Michel, D Wähnert, M Freistühler, M G Laukoetter, S Rehberg, M J Raschke, P Garcia
BACKGROUND: Secondary abdominal compartment syndrome is well known as a life-threatening complication in critically ill patients in an intensive care unit. Massive crystalloid fluid resuscitation has been identified as the most important risk factor. The time interval from hospital admittance to the development of manifest abdominal compartment syndrome is usually greater than 24 hours. In the absence of any direct abdominal trauma, we observed a rapidly evolving secondary abdominal compartment syndrome shortly after hospital admittance associated with massive transfusion of blood products and only moderate crystalloid resuscitation...
October 19, 2016: Journal of Medical Case Reports
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