Ultrasound-guided percutaneous transjejunal creation of neoanastomosis for the treatment of bilioenteric anastomotic occlusion.

A stricture of the bilioenteric anastomosis is a known complication of pancreaticoduodenectomy surgery and pediatric liver transplant. Occasionally, a complete biliary occlusion is encountered that cannot be treated utilizing endoscopic or conventional interventional radiology blunt recanalization techniques. In this article, we report 2 cases of successful sharp percutaneous ultrasound-guided retrograde creation of bilioenteric neoanastomosis in the setting of a complete biliary occlusion following Whipple surgery and liver transplant respectively.

Magnitude of rib fracture displacement predicts opioid requirements.

Introduction: It is unknown whether the magnitude of rib fracture (RF) displacement predicts pain medication requirements in blunt chest trauma patients.

Methods: Adult blunt RF patients undergoing computed tomography (CT) of the chest admitted to an urban Level 1 trauma center (2007-2012) were retrospectively reviewed. Pain management in those with displaced RF (DRF), nondisplaced RF (NDRF), or combined DRF and NDRF (CRF) was compared by univariate analysis.

Displacement Patterns of Blunt Rib Fractures and Their Relationship to Thoracic Coinjuries: Minimal Displacements Count.

Displacement patterns of rib fractures (RF) and their association with thoracic coinjuries and outcomes are unknown. This is a retrospective review of adult patients with blunt closed RF who underwent chest CT at a Level I trauma center (2007-2012). Displacement patterns of RF were compared among the three-dimensional planes using CT images.