Hollow viscus injury

Computed tomography (CT) plays an important role in trauma because imaging findings directly impact management. Advances in CT technology, specifically multienergy CT, have allowed for simultaneous acquisition of images at low and high kilovolt peaks. This technique allows for differentiation of materials given that materials have different absorption behaviors. Various multienergy CT postprocessing applications are helpful in the setting of trauma, including bone subtraction, virtual monoenergetic imaging, iodine-selective imaging, and virtual noncontrast imaging...

PURPOSE: This study aimed to evaluate the accuracy and outcomes of focused assessment with sonography for trauma (FAST) and determine the factors associated with true-positive FAST results. METHODS: The FAST results from 2016 to 2020 were retrospectively reviewed. Cases involving penetrating injury, transfer from other hospitals, age ≤ 16 years, prehospital arrest, and no confirmatory test were excluded. Intra-abdominal fluid was confirmed using computed tomography or operative findings...

Jejunal intramural hematoma (JIH) is rare. A 5-year-old girl, a known attention-deficit hyperactivity disorder child with paraneoplastic symptoms, on imaging showed a suspicion of Jejunal intramural mass with internal bleeding. Laparotomy showed a JIH. Evacuation of hematoma and Histopathological Examination (HPE) ruled out tumor. Possible explanation of the manifestation is suggested.

Pneumoperitoneum is the presence of free air within the peritoneal cavity and indicates perforation of a hollow viscus. However, it may also occur in the absence of perforation and in this case, it is called spontaneous pneumoperitoneum (SP). A 57-year-old female patient who was intubated and mechanically ventilated due to respiratory failure developed abdominal compartment syndrome (ACS) secondary to massive SP. Peritoneal lavage was performed for the patient both to achieve decompression and to support the diagnosis...

Imaging is a critical tool for the diagnosis and management of thoracic and abdominal injuries in pediatric patients. The location and mechanism of injury, the physical examination, and other clinical findings should guide emergency clinicians in the selection of the most appropriate imaging modality for the pediatric trauma patient. This supplement reviews the evidence for imaging decisions in the setting of pleural space, lung parenchyma, chest wall, cardiac, diaphragm, solid-organ, and hollow-viscus injuries in pediatric patients...

BACKGROUND: Penetrating diaphragmatic injuries are associated with a high incidence of posttraumatic empyema. We analyzed the contribution of trauma severity, specific organ injury, contamination severity, and surgical management to the risk of posttraumatic empyema in patients who underwent surgical repair of diaphragmatic injuries at a level 1 trauma center. METHODS: This is a retrospective review of the patients who survived more than 48 h. Univariate OR calculations were performed to identify potential risk factors...

Objectives Numerous previous studies investigated the impact of medical training settings on outcomes of hospitalized patients. However, the impact of teaching hospital status on outcomes of percutaneous paracentesis, to the best of our knowledge, has never been studied before. Methods Hospitalized patients who underwent percutaneous paracentesis were identified from the National Inpatient Sample database from 2016 to 2019 across the United States (US) teaching and non-teaching hospitals. Outcomes studied were differences in risk of mortality, postprocedural outcomes, and healthcare resource utilization...

BACKGROUND: Selective nonoperative management (SNOM) of abdominal gunshot wounds (GSWs) is increasingly used as computed tomography (CT) has become a diagnostic adjunct for the evaluation of intraabdominal injuries including hollow viscus injuries (HVIs). Currently, there is scarce data on the diagnostic accuracy of CT for identifying HVI. The purpose of this study was to determine the diagnostic accuracy of different CT findings in the diagnosis of HVI following abdominal GSW. METHODS: This retrospective single-center cohort study was performed from January 2015 to April 2019...

IMPORTANCE: Abdominal seat belt sign (SBS) has historically entailed admission and observation because of the diagnostic limitations of computed tomography (CT) imaging and high rates of hollow viscus injury (HVI). Recent single-institution, observational studies have questioned the utility of this practice. OBJECTIVE: To evaluate whether a negative CT scan can safely predict the absence of HVI in the setting of an abdominal SBS. DESIGN, SETTING, AND PARTICIPANTS: This prospective, observational cohort study was conducted in 9 level I trauma centers between August 2020 and October 2021 and included adult trauma patients with abdominal SBS...

BACKGROUND: The optimal observation time required to exclude hollow viscus injury in patients undergoing selective nonoperative management (SNOM) for abdominal stab wounds (SWs) remains unclear. The aim of this study was to determine the safe period of observation required before discharge. METHODS: In this prospective observational study, all patients who sustained an abdominal SW were screened for study inclusion (July 2018 to May 2021). The primary study outcome was time to SNOM failure, defined as the need for surgical intervention after an initial period of observation...

INTRODUCTION: Percutaneous endoscopic gastrostomy (PEG) has been available since the 1980s. Routine replacement is conducted at bedside with relatively few complications. Two replacement methods have come into practice: the percutaneous method and the endoscopic method. The laparoscopic method has recently become favorable in the pediatric population. PRESENTATION OF CASE: Herein, we describe a situation in which a gastrostomy tube was replaced at bedside on a patient with previous head and neck surgery for lingual cancer...

Introduction Pancreatic trauma is rare and is usually associated with adjacent organ and vascular injuries, which adds to the high morbidity and mortality. In the American Association for the Surgery of Trauma (AAST) pancreatic trauma (PT) grading system, the higher grades are a composite of less and more severe extents of injuries. We hereby present an observational study of PT with management based on an indigenous algorithmic approach. Our protocol incorporating both the extent of disruption of the main pancreatic duct (MPD) and its amenability to interventions (endoscopic, radiological, or surgical) is pragmatic...

INTRODUCTION: Caustic agents, also called corrosive agents, could be acids or alkali in nature. If ingested, these agents can injure any part of the aerodigestive tree. Extent of injury depends on the type, concentration, duration of exposure and volume of caustic agent ingested. Serious complications after caustic agent ingestion can occur both in the short term such as hollow viscus perforation and death and in the long term such as stricture formation causing obstruction and lifetime risk of development of carcinoma...

BACKGROUND: Chance fracture (CFx) with concomitant intra-abdominal injury has variable occurrence rates ranging from 33 to 89%. No single study has compared the incidence of simultaneous abdominal injury between pediatric and adult populations. This study compares the rate of simultaneous intra-abdominal injury and chance fracture in these populations. METHODS: A retrospective review of pediatric and adult patients with chance fracture in comparable pediatric and adult trauma centers was performed...

Objectives: The number of accident cases is increasing day by day, so as the challenges. With an emphasis on trauma care, the government started a 120 bedded level I trauma centre in northern India catering to a population of 2.8 million in June 2018. Through this article, we aimed to share our experience of blunt abdominal trauma management from a new level I trauma centre. Material and Methods: In this retrospective observational study, historical analysis of all available records from July 2018 to March 2020 was done...

BACKGROUND: There are an estimated 100,000 cases of abdominal injury (ABI) in the USA, annually resulting in over $12 billion in direct medical cost and $18 billion in lost productivity. This study assesses the timeliness, safety, and efficacy of the surgical management of abdominal injuries (ABIs), hollow viscus injuries (HVIs), and colonic injuries (CIs) for patients residing in New York State (NYS). METHODS: Using data from NYS's Statewide Planning and Research Cooperative System (SPARCS), we identified all trauma patients with ABI admitted between 2006 and 2015...

OBJECTIVE: Blunt abdominal aortic injury in pediatrics is a rare clinical entity with which most vascular surgeons have minimal experience. Evidence for management recommendations is limited. Herein we report a single institution's experience in the care of pediatric abdominal aortic injuries. METHODS: This is a retrospective review of consecutive pediatric patients diagnosed with blunt traumatic abdominal aortic injury at our institution between 2008 and 2019. RESULTS: Sixteen pediatric patients (50% male) were identified, ranging in age between 4-17 years...

Introduction: The large bowel is the second most commonly injured hollow viscus in penetrating abdominal trauma following the small bowel. Injuries to the colon are fairly common in times of war and the lessons learned in these instances have historically guided management. The objective of our research is to highlight current management principles as they are applied in a single trauma centre during the last two decades. Material and Method: retrospective review of our clinical experience was performed. Electronic health records from our institution were searched for injuries caused by external forces from January 2003 - October 2021...

BACKGROUND: Traumatic hollow viscus injury (THVI) is one of the most difficult challenges in the trauma setting. Computed tomography (CT) is the most common modality used to diagnose THVI; however, various performance outcomes of CT have been reported. We conducted a systematic review and meta-analysis to analyze how precise and reliable CT is as a tool for the assessment of THVI. METHOD: A systematic review and meta-analysis were conducted on studies on the use of CT to diagnose THVI...

Anastomotic leakage after intestinal resection is one of the most serious complications of surgical intervention for hollow viscus injury. Adequate vascular perfusion of the anastomotic site is essential to prevent anastomotic leakage. Near-infrared imaging using indocyanine green (NIR-ICG) is useful for the objective assessment of vascular perfusion. The aim of this study was to evaluate the association of NIR-ICG with intestinal and mesenteric injuries. This was a retrospective, single-center study of patients undergoing surgery for intestinal and mesenteric injuries...