Feasibility of remote CT colonography at two rural Native American medical centers.

Objective: Fort Defiance Indian Hospital and Tuba City Regional Health Care Center are two rural hospitals with limited availability of optical colonoscopy (OC) and other methods of colorectal cancer screening. Our goals were to determine whether adequate examinations could be obtained with remote supervision after brief onsite instruction and to share lessons learned in our experience with a remote CT colonography (CTC) screening program.

Materials And Methods: After brief onsite instruction, including performing a CTC examination on a volunteer to train the CT technologists, both sites began performing CTC using standard bowel preparation, fecal tagging, automatic insufflation, and low-dose technique.

Recombinant activated factor VII as an adjunct to packing for liver injury with hepatic venous disruption.

Injuries to the juxtahepatic veins represent a small proportion of all liver injuries but constitute the most challenging and deadly form of hepatic trauma. Recombinant activated factor VII, established as a crucial therapy for enhancing hemostasis in hemophiliacs with inhibitors, has also been used to correct coagulopathy after traumatic injury. We report two children with hepatic venous injury requiring perihepatic packing and recombinant activated factor VII to successfully control hemorrhage.