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Abdominal Trauma

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5. Assessment of abdominal trauma

Assessment of abdominal trauma Assessment of abdominal trauma - Differential diagnosis of symptoms | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Assessment of abdominal trauma Last reviewed: February 2019 Last updated: August 2018 Summary Trauma is a physical injury caused by transfer of energy to and within the person involved. Abdominal trauma is best categorised by mechanism as blunt or penetrating abdominal injury. The mechanism of injury (...) dictates the diagnostic work-up. As there is a broad spectrum of abdominal injuries, abdominal trauma patients are often difficult to assess. Confounding factors, such as associated extra-abdominal injuries or altered mental status (either from a head injury or intoxication), further complicate the evaluation. Enderson BL, Reath DB, Meadors J, et al. The tertiary trauma survey: a prospective study of missed injury. J Trauma. 1990 Jun;30(6):666-9. http://www.ncbi.nlm.nih.gov/pubmed/2352294?tool

2018 BMJ Best Practice

6. Abdominal ultrasound (FAST examination) in children with blunt torso trauma. A need or overestimation?

Abdominal ultrasound (FAST examination) in children with blunt torso trauma. A need or overestimation? Abdominal ultrasound (FAST examination) in children with blunt torso trauma. A need or overestimation? - Evidencias en pediatría Searching, please wait Show menu Library Management You did not add any article to your library yet. | Search Evidence-Based decision making Evidence-Based decision making Show menu Library Management You did not add any article to your library yet. × User Password (...) Log in × Reset password If you need to reset your password please enter your email and click the Send button. You will receive an email to complete the process. Email Send × Library Management × December 2017. Volume 13. Number 4 Abdominal ultrasound (FAST examination) in children with blunt torso trauma. A need or overestimation? Rating: 5 (1 Votes) Reviewers: , . | Newsletter Free Subscription Regularly recieve most recent articles by e-mail Subscribe × Newsletter subscription: Email Confirm

2018 Evidencias en Pediatría

7. A novel streamlined trauma response team training improves imaging efficiency for pediatric blunt abdominal trauma patients. (PubMed)

A novel streamlined trauma response team training improves imaging efficiency for pediatric blunt abdominal trauma patients. The morbidity and mortality of children with traumatic injuries are directly related to the time to definitive management of their injuries. Imaging studies are used in the trauma evaluation to determine the injury type and severity. The goal of this project is to determine if a formal streamlined trauma response improves efficiency in pediatric blunt trauma by evaluating (...) time to acquisition of imaging studies and definitive management.This study is a chart review of patients <18 years who presented to a pediatric trauma center following blunt trauma requiring trauma team activation. 413 records were reviewed to determine if training changed the efficiency of CT acquisition and 652 were evaluated for FAST efficiency. The metrics used for comparison were time from ED arrival to CT image, FAST, and disposition.Time from arrival to CT acquisition decreased from 37 (SD

2019 Journal of Pediatric Surgery

8. External validation of a clinical prediction rule for very low risk pediatric blunt abdominal trauma

External validation of a clinical prediction rule for very low risk pediatric blunt abdominal trauma Computed tomography (CT) is frequently used to identify intra-abdominal injuries in children with blunt abdominal trauma (BAT). The Pediatric Emergency Care Applied Research Network (PECARN) proposed a prediction rule to identify children with BAT who are at very low risk for clinically-important intra-abdominal injuries (CIIAI) in whom CT can be avoided.To determine the sensitivity (...) of this prediction rule in identifying patients at very low risk for CIIAI in our pediatric trauma registry.Retrospective review of our institutional trauma registry to identify patients with CIIAI. CIIAI included cases resulting in death, therapeutic intervention at laparotomy, angiographic embolization of intra-abdominal arterial bleeding, blood transfusion for intra-abdominal hemorrhage, and administration of intravenous fluids for two or more nights for pancreatic or gastrointestinal injuries. Patients were

2019 EvidenceUpdates

9. Diagnostic accuracy of emergency-performed focused assessment with sonography for trauma (FAST) in blunt abdominal trauma (PubMed)

Diagnostic accuracy of emergency-performed focused assessment with sonography for trauma (FAST) in blunt abdominal trauma Intra-abdominal hemorrhage due to blunt abdominal trauma is a major cause of trauma-related mortality. Therefore, any action taken for facilitating the diagnosis of intra-abdominal hemorrhage could save the lives of patients more effectively. The aim of this study was to determine the accuracy of focused assessment with sonography for trauma (FAST) performed by emergency (...) physicians.In this cross-sectional study from February 2011 to January 2012 at 7th Tir Hospital in Tehran (Iran), 120 patients with abdominal blunt trauma were chosen and evaluated for abdominal fluid. FAST sonography was performed for all the subjects by emergency residents and radiologists while they were blind to the other tests. Abdominal CTs, which is the gold standard, were done for all of the cases. SPSS 20.0 was used to analyze the results.During the study, 120 patients with abdominal blunt trauma

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2016 Electronic physician

10. Emergency ultrasound-based algorithms for diagnosing blunt abdominal trauma. (PubMed)

Emergency ultrasound-based algorithms for diagnosing blunt abdominal trauma. Ultrasonography (performed by means of a four-quadrant, focused assessment of sonography for trauma (FAST)) is regarded as a key instrument for the initial assessment of patients with suspected blunt abdominal and thoraco-abdominal trauma in the emergency department setting. FAST has a high specificity but low sensitivity in detecting and excluding visceral injuries. Proponents of FAST argue that ultrasound-based (...) clinical pathways enhance the speed of primary trauma assessment, reduce the number of unnecessary multi-detector computed tomography (MDCT) scans, and enable quicker triage to surgical and non-surgical care. Given the proven accuracy, increasing availability of, and indication for, MDCT among patients with blunt abdominal and multiple injuries, we aimed to compile the best available evidence of the use of FAST-based assessment compared with other primary trauma assessment protocols.To assess

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2015 Cochrane

11. Correlating abdominal pain and intra-abdominal injury in patients with blunt abdominal trauma (PubMed)

Correlating abdominal pain and intra-abdominal injury in patients with blunt abdominal trauma A thorough history and physical examination in patients with blunt abdominal trauma (BAT) is important to safely exclude clinically significant intra-abdominal injury (IAI). We seek to evaluate a correlation between self-reported abdominal pain, abdominal tenderness on examination and IAI discovered on CT or during exploratory laparotomy.This retrospective analysis assessed patients with BAT ≥13 years (...) old who arrived to the emergency department following BAT during the 23-month study period. Upon arrival, the trauma team examined all patients. Only those who underwent an abdominal and pelvic CT scan were included. Patients were excluded if they were unable to communicate or lacked documentation, had obvious evidence of extra-abdominal distracting injuries, had a positive drug or alcohol screen, had a Glasgow Coma Scale ≤13, or had a positive pregnancy screening. The primary objective

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2017 Trauma Surgery & Acute Care Open

12. Diagnostic accuracy of Focused Assessment with Sonography for Trauma for blunt abdominal trauma in the Eastern Region of Saudi Arabia (PubMed)

Diagnostic accuracy of Focused Assessment with Sonography for Trauma for blunt abdominal trauma in the Eastern Region of Saudi Arabia To determine the diagnostic accuracy of  Focused Assessment with Sonography for Trauma (FAST) in blunt abdominal trauma caused by motor vehicle accidents at our Hospital in Dhahran city.This descriptive, observational study was conducted in the Radiology Department at King Fahad Military Medical Complex   Dhahran, Saudi Arabia between September 2016 and September (...) 2017.  All adult patients (n=105) involved in motor vehicle accidents with blunt abdominal injury on presentation were retrospectively reviewed for FAST and CT scans for detection of free fluid. Focused assessment with sonography for trauma studies were conducted or supervised by senior registrar of general surgery (trauma team leader). Computed tomography findings were reviewed by 2 experienced radiologists. High and low-grade solid abdominal visceral (liver, spleen, kidney) injuries were

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2018 Saudi medical journal

13. Costal Margin Tenderness and the Risk for Intra-abdominal Injuries in Children with Blunt Abdominal Trauma. (PubMed)

Costal Margin Tenderness and the Risk for Intra-abdominal Injuries in Children with Blunt Abdominal Trauma. The risk of radiation exposure from computed tomography (CT) imaging in children is well recognized. Patient history and physical examination findings, including costal margin tenderness (CMT), influence a physician's decision to image a child with blunt torso trauma. The objective of this study was to determine the importance of CMT for identifying children with intraabdominal injuries (...) (IAI) found on CT and IAI undergoing acute intervention.We conducted an analysis of the Pediatric Emergency Care Applied Research Network (PECARN) IAI public use data set, representing a large prospective multicenter cohort study from May 2007 to January 2010. Isolated CMT was defined as CMT without other identified PECARN risk factors for IAI (i.e., abdominal or thoracic wall trauma, abdominal tenderness or pain, decreased breath sounds, or vomiting). Logistic regression was used to calculate

2018 Academic Emergency Medicine

14. The Impact of Prior Laparotomy and Intra-abdominal Adhesions on Bowel and Mesenteric Injury Following Blunt Abdominal Trauma. (PubMed)

The Impact of Prior Laparotomy and Intra-abdominal Adhesions on Bowel and Mesenteric Injury Following Blunt Abdominal Trauma. Early recognition of bowel and mesenteric injury following blunt abdominal trauma remains difficult. We hypothesized that patients with intra-abdominal adhesions from prior laparotomy would be subjected to visceral sheering deceleration forces and increased risk for bowel and mesenteric injury following blunt abdominal trauma.We performed a multicenter retrospective (...) cohort analysis of 267 consecutive adult trauma patients who underwent operative exploration following moderate-critical (abdominal injury score 2-5) blunt abdominal trauma, comparing patients with prior laparotomy (n = 31) to patients with no prior laparotomy (n = 236). Multivariable regression was performed to identify predictors of bowel or mesenteric injury.There were no significant differences between groups for injury severity scores or findings on abdominal ultrasound, diagnostic peritoneal

2018 World Journal of Surgery

15. Position of the abdominal seat belt sign and its predictive utility for abdominal trauma. (PubMed)

Position of the abdominal seat belt sign and its predictive utility for abdominal trauma. In a motor vehicle crash, compressive forces from the lap component of the seat belt may produce an abdominal abrasion/contusion known as the 'seat belt sign', and is associated with abdominal and lumbar injuries. Previous research has not taken into account the position of this sign in relation to the anterior superior iliac spine (ASIS). Our aim was to demonstrate an association between the seat belt (...) sign position in relation to ASIS and the presence of abdominal/lumbar injury.A mixed prospective and retrospective observational study of patients involved in a motor vehicle crash was conducted. The presence of a seat belt sign was recorded as above ASIS, at/below ASIS, or none. Injury data were extracted from discharge summaries, radiology reports and operation reports. Proportions of patients with injuries were compared across the three groups.Four hundred and sixty-four participants were

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2018 Emergency medicine Australasia

17. Trends in the Nature and Management of Serious Abdominal Trauma. (PubMed)

Trends in the Nature and Management of Serious Abdominal Trauma. There have been recommendations for increased non-operative management (NOM) of abdominal trauma in adults. To assess the impact of this trend and changes in the epidemiology of trauma, we examined the management of serious abdominal injuries and mortality, in Victorian major trauma patients 16 years or older, between 2007 and 2016.Using data from the population-based Victorian Trauma Registry, characteristics of patients who (...) abdominal trauma increased during the study period, there was a reduction in the proportion of patients managed with laparotomy and reduction in the adjusted odds of in-hospital mortality. Older patients, for whom management is influenced by the complex interplay of frailty and co-morbidities, had lower laparotomy rates.

2019 World Journal of Surgery

18. Effect of Abdominal Ultrasound on Clinical Care, Outcomes, and Resource Use Among Children With Blunt Torso Trauma: A Randomized Clinical Trial. (PubMed)

Effect of Abdominal Ultrasound on Clinical Care, Outcomes, and Resource Use Among Children With Blunt Torso Trauma: A Randomized Clinical Trial. The utility of the focused assessment with sonography for trauma (FAST) examination in children is unknown.To determine if the FAST examination during initial evaluation of injured children improves clinical care.A randomized clinical trial (April 2012-May 2015) that involved 975 hemodynamically stable children and adolescents younger than 18 years (...) treated for blunt torso trauma at the University of California, Davis Medical Center, a level I trauma center.Patients were randomly assigned to a standard trauma evaluation with the FAST examination by the treating ED physician or a standard trauma evaluation alone.Coprimary outcomes were rate of abdominal computed tomographic (CT) scans in the ED, missed intra-abdominal injuries, ED length of stay, and hospital charges.Among the 925 patients who were randomized (mean [SD] age, 9.7 [5.3] years; 575

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2017 JAMA

19. Hospital factors associated with higher costs in pediatric blunt abdominal trauma: A national study. (PubMed)

Hospital factors associated with higher costs in pediatric blunt abdominal trauma: A national study. Our objective was to evaluate hospital factors, including children's hospital status, associated with higher costs for blunt solid organ pediatric abdominal trauma.We queried the 2012 Healthcare Cost and Utilization Project (HCUP) Kid's Inpatient Database (KID) for patients 18 years or younger with low-grade and high-grade blunt abdominal trauma. We calculated total hospital costs and adjusted (...) cost ratios (CR) controlling for patient and hospital-level characteristics.The 2012 KID included 882 low-grade and 222 high-grade pediatric abdominal trauma patients. Median (interquartile range) per hospitalization costs were similar at children's and nonchildren's hospitals for both low-grade (children's = $6575 [$4333-$10,862], nonchildren's $7027 [$4230-$12,219] p = 0.47) and high-grade (children's = $10,984 [$6211- $20,007] nonchildren's $10,156 [$5439-$18,404] p = 0.55) groups. Adjusted cost

2019 Journal of Pediatric Surgery

20. Analysis of the use of upright abdominal radiography for evaluating intestinal perforations in handlebar traumas: Three case reports. (PubMed)

Analysis of the use of upright abdominal radiography for evaluating intestinal perforations in handlebar traumas: Three case reports. Intestinal perforations due to blunt abdominal handlebar trauma are difficult to diagnose. This report presents a retrospective analysis of 3 patients with intestinal perforations due to abdominal bicycle handlebar trauma who were diagnosed via upright abdominal radiography.All the patients lost their balance while riding a bicycle for leisure and had fallen (...) on the handlebar tip. The patients were initially misdiagnosed at different-level health centers despite various radiologic investigations performed.The patients' intestinal perforations were diagnosed via plain upright abdominal X-ray radiography (UAXR) in our institution.The children underwent exploratory laparotomy due to intestinal perforations. All the perforations were repaired either with primary closure or bowel resection and anastomosis with successful outcomes.Pneumoperitoneum due to intestinal

2019 Medicine

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