Many patients with blunt splenic injury are considered for nonoperative management and, with proper selection, the success rate is high. This paper aims to provide an update on the treatments and dilemmas of nonoperative management of splenic injuries in adults and to offer suggestions that may improve both consensus and patient outcomes.
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http://dx.doi.org/10.1136/tsaco-2017-000075 | DOI Listing |
J Surg Res
January 2025
Center for Injury Science, University of Alabama at Birmingham, Administration Bldg, Birmingham, Alabama. Electronic address:
Introduction: The management of adhesive small-bowel obstruction (aSBO) continues to have wide variation, with no one management strategy accepted as the optimal. The first objective was to evaluate the methods of management and the variations in the management of aSBO at our institution and evaluate the outcomes of those management strategies. The second objective was to compare our outcomes to those of a published study by which patients were managed using an institutional protocol for aSBO.
View Article and Find Full Text PDFJ Surg Res
January 2025
Department of Surgery, Stanford University School of Medicine, Stanford, California; S-SPIRE Center, Department of Surgery, Stanford University School of Medicine, Stanford, California.
Introduction: Previous research has demonstrated that after neoadjuvant therapy for rectal cancer, the sensitivity of magnetic resonance complete response (mrCR) for detecting pathologic complete response (pCR) in the surgical specimen ranges from 74 to 94%. Patient and provider interest in nonoperative management of rectal cancer that responds favorably to neoadjuvant therapy has grown, necessitating stronger evidence for how well radiographic complete response truly predicts pCR. We sought to determine the current association between mrCR and pCR in locally advanced rectal cancer.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Surgery, Hospital de Vila Franca de Xira, Vila Franca de Xira, Lisboa, Portugal.
Non-operative management is the standard of care for blunt spleen trauma in stable patients in the absence of other abdominal injuries. This is a case report of a male patient in his 60s who presented to the emergency room with abdominal pain 2 days after sustaining blunt abdominal trauma. The patient was haemodynamically stable, and CT scan revealed a severe spleen injury.
View Article and Find Full Text PDFThyroid
January 2025
Division of Endocrinology, Diabetes and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
In the era of molecular testing, thyroid nodules with indeterminate cytology are increasingly being managed nonoperatively. The false-negative rates of these molecular tests, and therefore missed malignancies, are not well defined in real-world clinical practice. This retrospective study of patients undergoing fine needle aspiration (FNA) biopsy at our health system between November 2017 and March 2022 included nodules with The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) III and IV cytology and negative, currently negative, or negative but limited ThyroSeq version 3 (TSv3) results.
View Article and Find Full Text PDFCan J Anaesth
January 2025
Department of Anesthesiology, Perioperative and Pain Medicine, Alberta Health Services and Cumming School of Medicine, University of Calgary, South Health Campus, 4448 Front St. SE, Calgary, AB, T3M 1M4, Canada.
Purpose: We report the use of a pericapsular nerve group (PENG) cryoneurolysis for longer-term analgesia in a patient with a hip fracture and severe medical comorbidities as an alternative to hip fracture surgery.
Clinical Features: A frail but lucid and fully autonomous 97-yr-old female from an assisted living facility sustained a subcapital fracture of her right proximal femur following a ground level fall. She had significant comorbidities including end-stage respiratory disease.
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