[Associated factors to non-operative management failure of hepatic and splenic lesions secondary to blunt abdominal trauma in children].

Introduction: The non operative management (NOM) is the standard management of splenic and liver blunt trauma in pediatric patients.Hemodynamic instability and massive transfusions have been identified as management failures. Few studies evaluate whether there exist factors allowing anticipation of these events.

Non-operative management versus operative management in high-grade blunt hepatic injury.

Background: Surgery used to be the treatment of choice in cases of blunt hepatic injury, but this approach gradually changed over the last two decades as increasing non-operative management (NOM) of splenic injury led to its use for hepatic injury. The improvement in critical care monitoring and computed tomographic scanning, as well as the more frequent use of interventional radiology techniques, has helped to bring about this change to non-operative management. Liver trauma ranges from a small capsular tear, without parenchymal laceration, to massive parenchymal injury with major hepatic vein/retrohepatic vena cava lesions.

Diagnostic performance of CT esophagography in patients with suspected esophageal rupture.

Esophageal rupture is a surgical catastrophe. The gold standard for diagnosing is iodine, water-soluble contrast medium esophagography. CT esophagography has shown promising results.

[Surgical treatment of blunt liver trauma, indications for surgery and results].

Introduction: The liver is the most frequently injured organ in blunt abdominal trauma. Patients that are hemodynamically unstable must undergo inmmediate surgical treatment. There are 2 surgical approaches for these patients; Anatomical Liver resection or non-anatomic liver resection.

Laparoscopic repair for perforated peptic ulcer disease.

Background: Perforated peptic ulcer is a common abdominal disease that is treated by surgery. The development of laparoscopic surgery has changed the way to treat such abdominal surgical emergencies. The results of some clinical trials suggest that laparoscopic surgery could be a better strategy than open surgery in the correction of perforated peptic ulcer but the evidence is not strongly in favour for or against this intervention.

Tranexamic acid for reducing mortality in emergency and urgent surgery.

Background: Emergency or urgent surgery, which can be defined as surgery which must be done promptly to save life, limb, or functional capacity, is associated with a high risk of bleeding and death. Antifibrinolytic agents, such as tranexamic acid, inhibit blood clot breakdown (fibrinolysis) and can reduce perioperative bleeding. Tranexamic acid has been shown to reduce the need for a blood transfusion in adult patients undergoing elective surgery but its effects in patients undergoing emergency or urgent surgery is unclear.

[Efficacy of multidetector computed angiotomography in the diagnosis of limb arterial injuries].

Objective: To determine the diagnostic usefulness of multidetector computed angiotomography in the diagnosis limb arterial injuries in patients with suspicion of arterial injury with no indication of immediate surgery.

Methods: Non-invasive 64-channel multidetector computed tomography (MDCT) was performed on 99 limbs suspected of having a traumatic vascular injury over a 44-month period between August 2004 and April 2008. The results were interpreted by the duty radiologist and his findings were compared with those from surgery or clinical follow-up.

Best timing for thoracoscopic evacuation of retained post-traumatic hemothorax.

Objective: To determine the best timing for thoracoscopic drainage of clotted hemothorax in order to ensure safe and effective results and to identify risk factors associated with drainage failure.

Materials And Methods: Cohort retrospective study of 139 consecutive patients who underwent thoracoscopic retained hemothorax drainage between April 1997 and May 2005.

Results: The procedure was successful in 102 patients (73.

Vascular trauma in Colombia: experience of a level I trauma center in Medellín.

Trauma has become a major health problem in Colombia. The large number of trauma patients has made San Vicente de Paul Hospital of Medellín a major national referred trauma center. Under-reporting is a major problem in Colombia, as in other underdeveloped countries, because of the absence of automated information systems.

Vascular trauma in Latin America: a regional survey.

As has been demonstrated, significant differences exist in demographics and the likelihood of accidents among Latin American countries; however, when figures were standardized, they showed a clear similarity in all the reviewed features of vascular trauma. A total of 66.4% of cases were managed solely on a clinical basis, with 78.