An infected chronic expanding haematoma treated with hip disarticulation.

This is a report of an anticoagulated patient with septic shock caused by an infected chronic expanding haematoma (CEH) that required hip disarticulation as a means of definitive surgical source control. As far as we know, we did not find any report of an infected giant CEH in the lower extremity as large as in the present patient.

Incidence, demographics and outcomes of patients with penetrating injury: a Japanese nationwide 10-year retrospective study.

Background: Unintentional injury remains the leading cause of death among Japanese people younger than 35 years; however, data are limited on the evaluation of characteristics, long-term mortality trend and mortality risk of patients with penetrating injury in Japan. This prevents the development of effective strategies for trauma care in patients with penetrating injury.

Methods: This retrospective cohort study investigated 313 643 patients registered in the Japan Trauma Data Bank (JTDB) dataset between 1 January 2009 and 31 March 2018.

Abdominal compartment syndrome secondary to a large retroperitoneal hematoma caused by ruptured gastroduodenal artery pseudoaneurysms in a patient with severe acute pancreatitis.

Background: Abdominal compartment syndrome (ACS) is a known complication of severe acute pancreatitis. It is typically secondary to visceral edema and aggressive fluid resuscitation, but rarely caused by a retroperitoneal hematoma due to ruptured visceral pseudoaneurysms.

Case Presentation: A 49-year-old man presented in shock with a history of heavy alcohol use and was transferred to the intensive care unit with a diagnosis of severe acute pancreatitis.

Task-shift Model in Pre-hospital Care and Standardized Nationwide Data Collection in Japan: Improved Outcomes for Out-of-hospital Cardiac Arrest Patients.

Out-of-hospital cardiac arrest (OHCA) is a growing worldwide public health concern. Previously, Japan experienced poorer outcomes among OHCA patients than in other high-income countries. In the early 1990s, through policy changes, the Japanese government introduced a task-shift model in pre-hospital care.

Impact of the COVID-19 pandemic on a trauma center of a university hospital in Japan.

Background: The Coronavirus disease 2019 pandemic caused the Japanese government to declare a State of Emergency on April 7, 2020. The aim of this study is to provide an overview of the effects of the pandemic on surgical cases at a university hospital trauma center.

Methods: An observational study was performed at a trauma center in a tertiary hospital in Tokyo, Japan.

Prospective evaluation of the "Stop the Bleed" program in Japanese participants.

Background: The Stop the Bleed (STB) program was developed to bring military bleeding control techniques into wider use among American civilians. It was introduced in Japan in case of mass casualty events during the Tokyo Olympic/Paralympic Games in 2021, and its effectiveness was prospectively evaluated.

Methods: Japanese physicians certified as STB instructors held bleeding control basic training courses from April to July 2019.

Hybrid emergency room system improves timeliness of angioembolization for pelvic fracture.

Background: Timely angioembolization (AE) is known to improve outcomes of patients with hemorrhage resulting from pelvic fracture. The hybrid emergency room system (HERS) is a novel trauma resuscitation room equipped with a computed tomography scanner, fluoroscopy equipment, and an operating room setup. We hypothesized that the HERS would improve the timeliness of AE for pelvic fracture.

Emergency trauma laparotomy and/or thoracotomy in the emergency department: risks and benefits.

Background: It is not mandatory for Japanese trauma centers to have an operating room (OR) and OR team available 24 hours a day/7 days a week. Therefore, emergency laparotomy/thoracotomy is performed in the emergency department (ED). The present study was conducted to assess the safety of this practice.

Performing Trauma Surgery in the Emergency Room Impacts the Timeliness of Surgery.

Background: Our institution has emergency rooms (ERs) with an operating room (OR) setup, which enables surgeons to perform thoracotomy and/or laparotomy for trauma patients without transferring patients to the OR. We hypothesized that the ERs with an OR setup improve the timeliness of surgery for trauma patients.

Materials And Methods: Data were reviewed from trauma patients who underwent emergency surgeries performed by our acute care surgery group from April 2013 to June 2017.

Investigation of optimal position for implantable loop recorders by potential mapping with Reveal DX.

Background: Electrode positioning is important for the operation of implantable loop recorders (ILRs). This study aimed to investigate optimal electrode positions for the implantation of ILRs.

Methods: Fifteen male subjects participated in the study and R wave amplitude data were collected from 15 areas in the left anterior chest area, with 4 variations of electrode angles and body positions.

Pulmonary alveolar proteinosis in a patient with Behcet's disease.

Secondary pulmonary alveolar proteinosis (PAP) has been described in several clinical settings that can be grouped into three main categories: infections of the lung; haematological malignancies and other conditions that alter the patient's immune status; and exposure to inhaled chemicals and minerals. Recent studies reported that anti-granulocyte-macrophage colony-stimulating factor (GM-CSF) antibody was present in the serum of patients with idiopathic PAP but not in patients with secondary PAP or in normal subjects. The present report describes the interesting case of a patient with Behcet's disease and PAP.