An incidental finding of carcinoid tumor of the cystic duct.

Cystic duct carcinoids are extremely rare tumors. We present a 58-year-old female with carcinoid tumor found within the cystic duct margin following laparoscopic cholecystectomy. She subsequently underwent surgical resection with a Roux-en-Y hepaticojejunostomy.

Railway train versus motor vehicle collisions: a comparative study of injury severity and patterns.

Objective: This study compares the demographics, injury severity, resource use, and injury patterns of patients involved in railway train-motor vehicle (RT-MV) to motor vehicle-motor vehicle (MV-MV) collisions.

Methods: Retrospective trauma registry review of 74 RT-MV and 1,931 MV-MV consecutive patients, age more than 14 years, presenting to two Level I trauma centers, January of 1991 to May of 1998.

Results: Compared with MV-MV, RT-MV had significantly more males (72% vs.

Retrospective analysis of the adequacy of oral contrast material for computed tomography scans in trauma patients.

Background: This study examined the adequacy of oral contrast (OC) in adult trauma patients, the differences in the incidence of pathology and other patient characteristics related to OC adequacy, and the incidence of OC-associated emesis.

Methods: The cases of 129 adult trauma patients were reviewed from January to December 1996 for utilization of OC, administration time, time to computed tomography (CT), and emesis within 4 hours. CT films were reviewed for adequacy of OC (AC = adequate contrast, IC = inadequate contrast) and pathology.

Shock index as a marker for significant injury in trauma patients.

Objective: To determine whether the shock index (SI), defined as the ratio of heart rate (HR) to systolic blood pressure (SBP), is a useful marker for significant injury in trauma patients.

Methods: A retrospective database analysis was used to relate the SI to the clinical measures: death within 24 hours, injury severity score (ISS) > or = 16, intensive care unit (ICU) stay > or = 1 day, and amount of blood transfused (BT) > or = 2 units. Consecutive trauma patients seen at one level I trauma center over a 24-month period were reviewed; excluded were patients not requiring trauma team consultation, or those with either incomplete records, severe head injury (Glasgow Coma Scale score < or = 8), or age < 14 years.