Blunt diaphragmatic lesions (BDL) are uncommon in trauma patients, but they should be promptly recognized as a delayed diagnosis increases morbidity and mortality. It is well known that BDL are often overlooked at initial imaging, mainly because of distracting injuries to other organs. Sonography may directly depict BDL only in a minor number of cases. Chest X-ray has low sensitivity in detecting BDL and lesions can be reliably suspected only in case of intra-thoracic herniation of abdominal viscera. Thanks to its wide availability, time-effectiveness and spatial resolution, multi-detector computed tomography (CT) is the imaging modality of choice for diagnosing BDL; several direct and indirect CT signs are associated with BDL. Given its high tissue contrast resolution, magnetic resonance imaging can accurately depict BDL, but its use in an emergency setting is limited because of longer acquisition times and need for patient's collaboration.
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http://dx.doi.org/10.4329/wjr.v8.i10.819 | DOI Listing |
Int J Mol Sci
December 2024
Department of Anesthesiology & Perioperative Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Aging disrupts multiple homeostatic processes, including autophagy, a cellular process for the recycling and degradation of defective cytoplasmic structures. Acute treatment with the autophagy inhibitor chloroquine blunts the maximal forces generated by the diaphragm muscle, but the mechanisms underlying neuromuscular dysfunction in old age remain poorly understood. We hypothesized that chloroquine treatment increases the presynaptic retention of the styryl dye FM 4-64 following high-frequency nerve stimulation, consistent with the accumulation of unprocessed bulk endosomes.
View Article and Find Full Text PDFFront Surg
December 2024
Department of Surgery, University Medical Centre Utrecht, Utrecht, Netherlands.
Background: A traumatic diaphragm defect is a rare injury. A missed diaphragm injury may cause serious morbidity and mortality. Detection rate during the first assessment of trauma patients is notoriously low.
View Article and Find Full Text PDFBMJ Case Rep
December 2024
Department of Acute, Emergency and Trauma Surgery, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
A woman in her 40s self-presented to an emergency department in a major trauma centre with severe right-sided abdominal pain, a tender right upper quadrant mass and chest pain. Diagnostic imaging showed a previously undiagnosed diaphragmatic hernia containing strangulated right colon. The patient had been the victim of a high-energy road traffic accident 18 months earlier, but at that time had not presented to hospital or undergone any outpatient investigation.
View Article and Find Full Text PDFAm J Surg
December 2024
Division of Acute Care and Trauma Surgery, Department of Surgery, Kern Medical Center, 1700 Mount Vernon Ave, Bakersfield, CA, 93306, USA. Electronic address:
Introduction: This study discusses a tertiary trauma center's experience involving traumatic pancreatic injuries, focusing on identification, management, and complications, aiming to provide a valuable contribution to the literature on pancreatic trauma management.
Methods: We conducted a five year (2019-2023) retrospective analysis utilizing trauma registry data to identified pancreatic injuries in tier 1 and 2 activations. Pancreatic Organ Injury Scaling (OIS) and overall injury severity (ISS) was assessed using AAST scoring.
Injury
November 2024
Department of Research, The Medical Research Circle (MedReC), Goma, Democratic Republic of the Congo. Electronic address:
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