Traumatic pancreatic injuries and treatment outcomes: An observational retrospective study from a high-volume tertiary trauma center.

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.

Outcomes of children transferred to a pediatric trauma center after blunt abdominal trauma: A 10-year experience.

Background: Most injured children are initially seen at non-pediatric hospitals, then transferred to a pediatric trauma center for definitive care. Published outcomes of transferred children with blunt abdominal trauma (BAT) are sparse. Our objective is to describe this population and their disposition at a pediatric trauma center.

Selective nonoperative management of abdominal gunshot wounds: What you need to know.

Since the 1990s, there has been a slow but steady adoption of selective nonoperative management (SNOM) for abdominal gunshot wounds (GSW). Multiple studies have shown that SNOM is feasible and can be performed safely, even at trauma centers with low penetrating trauma volumes. The principles of SNOM for abdominal GSW consists of (1) careful patient selection, (2) diagnostic workup with CT, and (3) clinical observation.

Inferior vena cava injuries: Are we doing what we really must?

Objectives: The inferior vena cava (IVC) is one of the most frequent injured intra-abdominal vessels and its treatment requires prompt action. Despite advances in reanimation in last decades, there has not been proportional improvement in IVC mortality. This report aims to discuss the mortality predictive factors including the adherence to balanced reanimation and damage control surgery (DCS) in daily trauma assistance, their repercussions on outcomes, comparing our institution outcomes to literature.

Analysis of outcomes of penetrating colonic injuries managed with or without fecal diversion.

Traumatic colorectal injuries can be managed by either fecal diversion or primary repair / resection and anastomosis. We aimed to study differences in outcomes in adult patients managed with or without fecal diversion at time of initial operation. The National Trauma Databank (NTDB) was used to identify adult patients (ages 18-64 years) with penetrating colonic injuries for the years 2013-2015.

Management of Inferior vena cava injury in a resource limited setup: A rare case report.

Introduction And Importance: Traumatic injuries of the inferior Vena Cava (IVC) are rare among traumatic abdominal injuries. It accounts for fewer than 5 % of penetrating injuries and 0.5 % of blunt trauma injuries.

Rare Incidental Finding of Multiple Pseudoaneurysms After Imaging-Guided Kidney Biopsy in a Patient With Lupus Nephritis: A Case Report and Literature Review.

Renal pseudoaneurysms are serious and rare vascular lesions. They can be seen in vasculitis or, more commonly, after renal biopsy, percutaneous renal surgery, penetrating trauma, and less frequently due to blunt renal trauma. We present the case of a 28-year-old woman with lupus nephritis accompanied by the incidental finding of renal pseudoaneurysms in both kidneys after an elective percutaneous renal biopsy of the left kidney.

Timing of surgery for children and adolescents sustaining complete traumatic spinal cord injury.

Objective: Spinal cord injury (SCI) trials have historically underrepresented pediatric patients. There are limited pediatric data examining the influence of surgical timing on complications and mortality for children and adolescents who have sustained complete traumatic SCI.

Methods: The following multicenter cohort study used Trauma Quality Improvement Program data from 2010 to 2020.

[Thoracoabdominal Trauma Caused by Blast and Gunshot Injuries].

In Germany, blast and gunshot injuries are uncommon but complex injury entities. Due to the global political situation, terrorist attacks, accidents, or acts of violence, these injuries are potentially part of the reality of care for every anaesthetist, surgeon, and emergency physician. In principle, this type of injury should be treated in a trauma centre with appropriate expertise, but the knowledge of basic treatment principles is necessary for all practitioners.

A novel conformable embolic for selective transarterial embolization of acute hemorrhages: a technical note.

Background: Obsidio conformable embolic (OCE, Boston Scientific, MA) is a novel, radiopaque and conformable embolic. The purpose of this report is to describe its use for treatment of acute intra-abdominal hemorrhages.

Methods And Results: Three patients presented with acute hemorrhage and were treated with OCE, including post-paracentesis hemorrhage, penetrating trauma to the liver, and blunt trauma in the spleen.

Serum albumin nadir as marker of inflammatory response in abdominal trauma.

Background: Serum albumin levels decrease following major trauma, for various reasons. We postulated that the serum albumin nadir (SAN) level would correlate negatively with severity of physiological insult.

Methodology: This retrospective cohort study included all patients with abdominal trauma admitted to the Trauma Intensive Care Unit at Inkosi Albert Luthuli Central Hospital during 2017 and 2018.

Scoping it Out: The Use of Laparoscopy After Penetrating Trauma in Stable Children.

Introduction: In stable children with penetrating abdominal trauma, literature regarding the use of laparoscopy (LAP) remains limited. Given increasing evidence in favor of LAP for selective adult trauma patients, we reviewed contemporary practices and outcomes in pediatric trauma patients.

Methods: The American College of Surgeons (ACS) Trauma Quality Programs data was utilized to identify children (<18 years) from 2016 to 2021 with a penetrating abdominal injury who underwent surgery within 24 h of admission.

Role of preoperative CT imaging in penetrating thoraco-abdominal injuries: A multicenter study of urban trauma centers.

Introduction: Management of penetrating thoracoabdominal (PTA) injuries with signs of hemorrhage have warranted operative intervention but improved imaging capabilities have redefined interventions required. We examined outcomes of hemodynamically stable patients undergoing preoperative CT imaging with the hypothesis that CT imaging would decrease OR time without delaying OR arrival.

Methods: A retrospective multicenter study was performed amongst four urban trauma centers examining hemodynamically stable patients with PTA injuries requiring operative intervention from January 2017-December 2021.

Indocyanine Green Fluorescence Angiography (ICG-FA) in the management of intestinal injuries following penetrating abdominal trauma: a case-control study comparing postoperative outcomes.

Background: The surgical management of penetrating hollow visceral injuries includes primary repair or exteriorization. Tissue perfusion at the site of gastrointestinal suture repair may be challenging to assess and is vulnerable to local energy transfer-related injury, micro- or macro-circulatory insufficiency, or splanchnic vasoconstriction for various reasons. Breakdown of suture lines can lead to potentially life-threatening complications.

CT imaging of clinically significant abdominopelvic injuries in the damage control surgery patient.

Purpose: Damage Control Surgery (DCS) refers to a staged laparotomy performed in patients who have suffered severe blunt or penetrating abdominopelvic trauma with the goal of managing critical injuries while avoiding life threatening metabolic derangements. Within 24 h of the initial laparotomy, computed tomography (CT) is used to assess the full extent of injuries. The purpose of this study was to assess the incidence of clinically significant unknown abdominopelvic injuries which required further dedicated surgical or interventional radiology management and failed surgical repairs identified on CT following initial laparotomy.

Blunt and Penetrating Injury to the Bowel: A Review.

Traumatic injuries to the small and large bowel are common and can be highly morbid. Identifying these injuries, especially in stable patients who suffer blunt trauma, can be challenging. It is critical that traumatic bowel injuries are diagnosed in a timely fashion as delays in diagnosis and treatment are associated with worse outcomes.

Robotic availability, not payor status, determines access to robotic emergency general surgery hernia repair in California and Florida.

Background: Previous studies have demonstrated that access to robotic surgery is influenced by socioeconomic factors, including insurance status. The 2010 Affordable Care Act established an avenue for states to expand Medicaid coverage, which has increased access to surgical care for many conditions. We hypothesized that socioeconomic disparities in access to robotic repair of non-elective emergency general surgery (EGS) hernias are less prevalent in California, a Medicaid expansion state, compared to Florida, which has not adopted Medicaid expansion.