Background: Patients with hollow viscus injury (HVI) are often a cause for diagnostic uncertainty. The incidence and outcomes of patients suffering hollow viscus injury secondary to major trauma have not been previously described in New Zealand. These metrics are important to guide quality improvement and resource allocation. The aim of our study is to define the incidence, outcomes and effect of delayed intervention on patients admitted to hospital with hollow viscus injury secondary to blunt abdominal trauma in the Northern region of New Zealand.
Methods: A 4-year multicentre retrospective study was performed in the Northern region of New Zealand between 1 July 2015 and 30 June 2019. A primary cohort of patients with confirmed hollow viscus injury secondary to blunt abdominal injury, who underwent a laparotomy, were assessed. The primary outcome measures were incidence, 30-day mortality and morbidity. Secondary outcomes included the effect of timing of surgical intervention.
Results: The incidence of hollow viscus injury in the region was 2.03 per 100 000. The 30-day mortality rate was 5% and the 30-day morbidity rate was 82%. Immediate surgical intervention was carried out in 36%, early surgical intervention in 56% and delayed surgical intervention in 8%.
Conclusion: The incidence of hollow viscus injury is in keeping with similar studies, but with lower mortality and higher morbidity. The rate of immediate or early surgical intervention was high. These findings are important to clinicians managing patients with major trauma and those involved in planning and allocation of resources.
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http://dx.doi.org/10.1111/ans.16883 | DOI Listing |
Int J Surg Case Rep
January 2025
Department of Surgery, Vassar Brothers Medical Center, Nuvance Health, 45 Reade Pl, Poughkeepsie, NY 12601, United States of America.
Introduction: Vascular Ehlers Danlos syndrome (vEDS) is a heritable connective tissue disorder characterized by vascular, solid organ, and hollow viscus fragility. Herein we report a patient with vEDS who presented with a large spontaneous subcapsular liver hemorrhage. This case highlights the challenges associated with managing vEDS patients and discusses approaches to optimize their care.
View Article and Find Full Text PDFCureus
November 2024
Microbiology, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru, IND.
This case report details the clinical management and implications of infection with pan-drug-resistant in a 50-year-old male admitted and diagnosed with acute peritonitis due to hollow viscus perforation, highlighting an emerging challenge in healthcare settings. Following emergency laparotomy and intensive care admission, the patient was catheterized to assist urine drainage and subsequent urine bacterial culture which yielded pan-drug-resistant , signifying a notable instance of nosocomial infection by a multi-drug-resistant organism. Despite the organism's resistance to broad-spectrum antibiotics, clinical improvement was observed with levofloxacin treatment, underlining the potential discrepancy between in vitro resistance patterns and in vivo response, particularly in urinary tract infections (UTIs) where urine drug concentrations are pivotal.
View Article and Find Full Text PDFSigmoid volvulus during pregnancy is an extremely rare condition that presents as intestinal obstruction and can lead to severe complications for both the mother and fetus if not promptly diagnosed and treated. To our knowledge, this is the first documented case in Yemen. We report a case of a 39-year-old pregnant woman at 32 weeks of gestation who presented with acute abdominal pain, constipation, and signs of peritonitis.
View Article and Find Full Text PDFJ Trauma Acute Care Surg
November 2024
From the Department of General, Thoracic, and Fetal Surgery (W.R.J., A.L.M.C., R.H., M.A., M.L.N., G.N.), Children's Hospital of Philadelphia; and Department of General Surgery (W.R.J.), Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Background: Blunt hollow viscus injuries (HVIs) are relatively rare and difficult to diagnose. Whether a delay in operative intervention impacts outcomes for pediatric patients with blunt HVI has not been investigated via analysis of multicenter databases.
Methods: We queried the Trauma Quality Improvement Program database from 2016 to 2020 for patients younger than 18 years who underwent an operation of the stomach, small intestine, large intestine, or rectum within 72 hours of emergency department arrival after blunt injury.
J Surg Case Rep
November 2024
General Surgery Department, Unidade Local de Saúde de Lisboa Ocidental, E.P.E., Estrada Forte do Alto Duque, 1449-005, Lisboa, Portugal.
Pneumoperitoneum, characterized by the presence of air in the peritoneal cavity, is usually associated with severe clinical conditions, such as perforations of hollow viscera, often requiring urgent surgical intervention. However, in rare cases, pneumoperitoneum occurs without an identifiable cause, thus classified as idiopathic pneumoperitoneum. We present two clinical cases of women who developed pneumoperitoneum after extensive gynecological surgeries.
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