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Splenic Injury

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2761. Purification of a 100 kDa phospholipase A2 from spleen, lung and kidney: antiserum raised to pig spleen phospholipase A2 recognizes a similar form in bovine lung, kidney and platelets, and immunoprecipitates phospholipase A2 activity. Full Text available with Trip Pro

Purification of a 100 kDa phospholipase A2 from spleen, lung and kidney: antiserum raised to pig spleen phospholipase A2 recognizes a similar form in bovine lung, kidney and platelets, and immunoprecipitates phospholipase A2 activity. Phospholipase A2 (PLA2) plays a key role in the production of intracellular and extracellular chemical mediators such as arachidonic acid, eicosanoids and platelet-activating factor, which modulate membrane channel activity, signal transduction, are vasoactive (...) and chemotactic, and are implicated in many pathophysiological mechanisms of inflammation and tissue injury. We previously identified, purified and characterized an arachidonic acid-selective cytosolic 100-110 kDa PLA2 from bovine platelets and rat kidney that is activated during cell stimulation. The purification schemes previously published resulted in low yields of enzyme, insufficient for extensive biochemical characterization. We report the purification of a large-molecular-mass (100 kDa) PLA2 from pig

1993 Biochemical Journal

2762. Congenital cleft spleen with CT scan appearance of high-grade splenic laceration after blunt abdominal trauma. (Abstract)

Congenital cleft spleen with CT scan appearance of high-grade splenic laceration after blunt abdominal trauma. The spiral computed tomography (CT) scan has made the diagnosis of traumatic injury increasingly rapid and accurate, especially in cases of solid parenchymal organ injury that follows blunt abdominal trauma. Nonetheless, this valuable method of diagnosis can be confounded when anatomical variances are encountered in the setting of concomitant associated injuries. We present here a case (...) where a congenitally bi-lobed spleen was diagnosed by CT scan as an apparent high-grade splenic laceration, prompting emergent laparotomy.

2003 Journal of Emergency Medicine

2763. Splenic artery embolization for post-traumatic splenic artery pseudoaneurysm in children. (Abstract)

Splenic artery embolization for post-traumatic splenic artery pseudoaneurysm in children. Although rare, traumatic splenic artery pseudoaneurysm (SAP) can be life threatening. The diagnostic approaches as well as the methods of treatment of SAP are yet to be determined. We present the case of a 10-year-old boy treated conservatively for a grade III blunt splenic injury (BSI). The child was discharged to home after a 5-day uneventful hospitalization but was found on routine follow-up CT scan (...) to have a large SAP. The pseudoaneurysm was successfully angiographically embolized and subsequent abdominal CT demonstrated successful resolution of the pseudoaneurysm with a small residual splenic cyst. We reviewed the eight cases of post-traumatic SAP in children that have been published in the English literature. Unlike SAP in adult patients, the severity of the splenic injury does not have predictive value for development of SAP in children. Abdominal pain was the most frequent symptom of SAP

2004 Journal of Trauma

2764. Radiofrequency ablation for controlling iatrogenic splenic injury Full Text available with Trip Pro

Radiofrequency ablation for controlling iatrogenic splenic injury 19936764 2010 06 16 2016 11 25 1432-1262 25 5 2010 May International journal of colorectal disease Int J Colorectal Dis Radiofrequency ablation for controlling iatrogenic splenic injury. 667-8 10.1007/s00384-009-0850-8 Dai Wing Chiu WC Ng Kelvin K KK Chok Kenneth S KS Cheung Tan To TT Poon Ronnie T RT Fan Sheung Tat ST eng Case Reports Letter 2009 11 21 Germany Int J Colorectal Dis 8607899 0179-1958 IM Aged Catheter Ablation (...) methods Hemostasis Humans Iatrogenic Disease prevention & control Male Radiography, Abdominal Spleen diagnostic imaging injuries pathology surgery Splenectomy Tomography, X-Ray Computed 2009 10 30 2009 11 26 6 0 2009 11 26 6 0 2010 6 17 6 0 ppublish 19936764 10.1007/s00384-009-0850-8 PMC2946541

2009 International journal of colorectal disease

2765. Conservative Management of a Splenic Injury Related to Percutaneous Nephrostolithotomy Full Text available with Trip Pro

Conservative Management of a Splenic Injury Related to Percutaneous Nephrostolithotomy Injury to intraperitoneal organs is unusual during percutaneous renal surgery. We report a splenic injury during upper pole percutaneous renal access for nephrostolithotomy that was managed conservatively.A 52-year-old male with left upper pole renal stones associated with a narrow upper pole infundibulum underwent upper pole renal access prior to percutaneous nephrostolithotomy (PCNL). The access

2006 JSLS : Journal of the Society of Laparoendoscopic Surgeons

2766. Management Options of Colonoscopic Splenic Injury Full Text available with Trip Pro

Management Options of Colonoscopic Splenic Injury Injury to the spleen during routine colonoscopy is an extremely rare injury. Diagnosis and management of the injury has evolved with technological advances and experience gained in the management of splenic injuries sustained in trauma. Of the 37 reported cases of colonoscopic splenic injury, 12 had a history of prior surgery or a disease process suggesting the presence of adhesions. Only 6 had noted difficulty during the procedure, and 31 (...) patients experienced pain, shock, or hemoglobin drop as the indication of splenic injury. Since 1989, 21/24 (87.5%) patients have been diagnosed initially using computed tomography or ultrasonography. Overall, only 27.8% have retained their spleens. None have experienced as long a delay as our patient, nor have any had an attempt at percutaneous control of the injury. This report presents an unusual case of a rare complication of colonoscopy and the unsuccessful use of one nonoperative technique

2006 JSLS : Journal of the Society of Laparoendoscopic Surgeons

2767. Management of spleen injuries in the adult trauma population: a ten-year experience Full Text available with Trip Pro

Management of spleen injuries in the adult trauma population: a ten-year experience Increasing awareness of the postoperative risks associated with splenectomies has led physicians and surgeons to use an alternative nonoperative strategy in handling traumatic spleen injuries. Our primary objective was to compare clinical outcomes between operative and nonoperative managements in adult patients with blunt splenic injuries. The secondary objective was to assess the changes in the patterns (...) of managing splenic injuries in the past 10 years.We performed a retrospective chart review on 266 adult patients with a spleen injury who were admitted to a tertiary trauma centre in Ontario between 1992 and 2001. We grouped and compared the patients according to the treatment received, either operative or nonoperative. Frequencies and confidence intervals are reported. Categorical variables were compared with chi-square or Fisher's exact tests. Continuous variables were reported as median and quartile

2006 Canadian Journal of Surgery

2768. Imaging and transcatheter arterial embolization for traumatic splenic injuries: review of the literature Full Text available with Trip Pro

Imaging and transcatheter arterial embolization for traumatic splenic injuries: review of the literature The spleen is the most commonly injured visceral organ in blunt abdominal trauma in both adults and children. Nonoperative management is the current standard of practice for patients who are hemodynamically stable. However, simple observation alone has been reported to have a failure rate as high as 34%; the rate is even higher among patients with high-grade splenic injuries (American (...) Association for the Surgery of Trauma [AAST] grade III-V). Over the past decade, angiography with transcatheter splenic artery embolization, an alternative nonoperative treatment for splenic injuries, has increased splenic salvage rates to as high as 97%. With the help of splenic artery embolization, success rates of more than 80% have also been described for high-grade splenic injuries. We discuss the role of computed tomography and transcatheter splenic artery embolization in the diagnosis and treatment

2008 Canadian Journal of Surgery

2769. The accuracy of FAST in relation to grade of solid organ injuries: A retrospective analysis of 226 trauma patients with liver or splenic lesion Full Text available with Trip Pro

The accuracy of FAST in relation to grade of solid organ injuries: A retrospective analysis of 226 trauma patients with liver or splenic lesion This study investigated the role of a negative FAST in the diagnostic and therapeutic algorithm of multiply injured patients with liver or splenic lesions.A retrospective analysis of 226 multiply injured patients with liver or splenic lesions treated at Bern University Hospital, Switzerland.FAST failed to detect free fluid or organ lesions in 45 of 226 (...) patients with spleen or liver injuries (sensitivity 80.1%). Overall specificity was 99.5%. The positive and negative predictive values were 99.4% and 83.3%. The overall likelihood ratios for a positive and negative FAST were 160.2 and 0.2. Grade III-V organ lesions were detected more frequently than grade I and II lesions. Without the additional diagnostic accuracy of a CT scan, the mean ISS of the FAST-false-negative patients would be significantly underestimated and 7 previously unsuspected intra

2009 BMC Medical Imaging

2770. Splenic Injury During Percutaneous Nephrolithotomy Full Text available with Trip Pro

Splenic Injury During Percutaneous Nephrolithotomy Injury to the spleen is a recognized complication during percutaneous renal access due to the close anatomical relationship of the spleen and the left kidney. However, transsplenic renal access is a rare complication of percutaneous nephrolithotomy and can also result in considerable morbidity, often requiring emergent splenectomy.We present our experience with splenic injury during percutaneous nephrolithotomy managed conservatively

2009 JSLS : Journal of the Society of Laparoendoscopic Surgeons

2771. Splenic Injury after Elective Colonoscopy Full Text available with Trip Pro

Splenic Injury after Elective Colonoscopy Splenic injury is a rare but serious complication of colonoscopy. Since the mid-1970s, 68 splenic injuries during colonoscopy including our 2 cases have been described. With the increasing use of colonoscopy, endoscopists, surgeons, and radiologists are more likely to encounter this unusual complication. Any cause of increased splenocolic adhesions, splenomegaly, or underlying splenic disease might be a predisposing factor for splenic injury during (...) of having splenic injury. Early recognition and interdisciplinary management are required to assure successful management of this potentially life-threatening injury. Patients with hemodynamic instability most often undergo surgery. We present 2 cases of splenic injury secondary to colonoscopy that required splenectomy.

2009 JSLS : Journal of the Society of Laparoendoscopic Surgeons

2772. IATROGENIC SPLENIC INJURY IN PERCUTANEOUS PROCEDURES Full Text available with Trip Pro

IATROGENIC SPLENIC INJURY IN PERCUTANEOUS PROCEDURES 18711625 2008 09 04 2018 11 13 0041-6193 77 2 2008 May The Ulster medical journal Ulster Med J Iatrogenic splenic injury in percutaneous procedures. 131-2 Khan Sana S Yousuf Muhammad I MI Bisharat M M Wali Jawed J eng Case Reports Letter Northern Ireland Ulster Med J 0417367 0041-6193 IM Biopsy adverse effects Diagnosis, Differential Humans Iatrogenic Disease Lung Diseases diagnosis Male Middle Aged Spleen injuries Splenic Diseases diagnostic

2008 The Ulster medical journal

2773. Management of adult blunt splenic injuries: comparison between level I and level II trauma centers. (Abstract)

Management of adult blunt splenic injuries: comparison between level I and level II trauma centers. The factors important in determining outcome when managing adult blunt splenic injuries continue to be debated. Whether trauma center level designation (Level I versus Level II) affects patient management has not been evaluated.We conducted a retrospective analysis of prospectively gathered data from the Pennsylvania Trauma Outcome Study database that collected information from 27 statewide (...) trauma centers (Level I [15], Level II [17]). Adult patients (ages > or = 16 years) with blunt splenic injuries (ICD-9-CM 865) were evaluated. Demographic data, injury data, and trauma center level designation were collected, and patient management, length of stay, and mortality were analyzed.There were 2,138 adult patients who suffered blunt splenic injuries during the study period (1998-2000). Patients treated at Level II trauma centers (n = 772) had a higher rate of operative treatment (38.2

2004 Journal of the American College of Surgeons

2774. Failure of observation of blunt splenic injury in adults: variability in practice and adverse consequences. (Abstract)

Failure of observation of blunt splenic injury in adults: variability in practice and adverse consequences. The Eastern Association for the Surgery of Trauma Multiinstitutional Workgroup reported a failure rate for nonoperative management of blunt splenic injury in adults of 10.8%. Sixty percent of the failures occurred within 24 hours of admission. The purpose of this multiinstitutional study by the Eastern Association for the Surgery of Trauma was to determine common variables in failure (...) of nonoperative management of blunt splenic injury in adults.Medical records were reviewed in a blinded fashion on 78 patients in whom nonoperative management failed. Statistical analysis was performed with ANOVA, extended chi-square, and Fisher's exact test; statistical significance was p<0.05.The 78 patients were categorized based on hemodynamic status. Forty-four percent were stable; 31% had transient hypotension or tachycardia that resolved with fluid infusion (responders); and 25% were unstable. Two

2005 Journal of the American College of Surgeons

2775. Variation in treatment of pediatric spleen injury at trauma centers versus nontrauma centers: a call for dissemination of American Pediatric Surgical Association benchmarks and guidelines. (Abstract)

%) and the subset with isolated spleen injury (0% to 3%). Independent risk factors for splenectomy included ages 15 to 19 years (p < 0.002), spleen injury severity (p < 0.0001), and presence of multiple injuries (p < 0.04). Adjusted odds ratio for risk of splenic operation in all patients with spleen injury was 2.122 (95% CI:1.455- 3.096) when treated at a nontrauma center (p < 0.0001).These multistate discharge data indicate that treatment of children with blunt spleen injury differs significantly when (...) Variation in treatment of pediatric spleen injury at trauma centers versus nontrauma centers: a call for dissemination of American Pediatric Surgical Association benchmarks and guidelines. American Pediatric Surgical Association consensus guidelines for children with blunt spleen injuries have been defined and validated in children's hospitals, but large administrative data sets indicate that only 10% to 15% of children with blunt spleen injuries are treated at children's hospitals. We sought

2006 Journal of the American College of Surgeons

2776. Profound hypothermic cardiopulmonary bypass facilitates survival without a high complication rate in a swine model of complex vascular, splenic, and colon injuries. (Abstract)

Profound hypothermic cardiopulmonary bypass facilitates survival without a high complication rate in a swine model of complex vascular, splenic, and colon injuries. Induction of a profound hypothermia for emergency preservation and resuscitation in severe hemorrhagic shock can improve survival from lethal injuries, but the impact of hypothermia on bleeding and infectious complications has not been completely determined.Uncontrolled hemorrhage was induced in 26 swine (95 to 135 lbs) by creating (...) an iliac artery and vein injury, and 30 minutes later, by lacerating the descending thoracic aorta. Through a left thoracotomy approach, profound total body hypothermia (10 degrees C) was induced (2 degrees C/min) by infusing cold organ preservation solution into the aorta. The experimental groups were: vascular injuries alone (group 1, n=10), vascular and colon injuries (group 2, n=8), and vascular, colon, and splenic injuries (group 3, n=8). All injuries were repaired during 60 minutes of low-flow

2007 Journal of the American College of Surgeons

2777. Failure of nonoperative management of splenic injuries: causes and consequences. Full Text available with Trip Pro

Failure of nonoperative management of splenic injuries: causes and consequences. Presenting patient characteristics can predict which patients will fail nonoperative therapy of blunt splenic injuries.Retrospective descriptive population study.All patients admitted with blunt splenic trauma were identified from a statewide trauma registry between January 1, 1995, and December 31, 2001.Patients were characterized as requiring immediate intervention or successful or failed nonoperative management (...) associated with failure of nonoperative management of blunt splenic injuries.Two thousand two hundred forty-three patients met criteria for inclusion in the study. Six hundred ten patients (27%) underwent immediate splenectomy, splenorrhaphy, or splenic embolization (within 4 hours). Of the remaining 1633 patients who were admitted with planned nonoperative management, 252 patients (15%) failed. Of the injury and patient characteristics reviewed, being older than 55 years and having an ISS higher than 25

2005 Archives of Surgery

2778. Trends in operative management of pediatric splenic injury in a regional trauma system. (Abstract)

a relatively short time interval, often without simultaneous adjustment for confounding variables. The objective of this study was to characterize the variation in operative versus nonoperative management of blunt splenic injury in children in nontrauma hospitals and in trauma centers with varying resources for pediatric care within a regionalized trauma system in the past decade.The study population included all children who were younger than 19 years and had a diagnosis of blunt injury to the spleen (...) Trends in operative management of pediatric splenic injury in a regional trauma system. Selective nonoperative management of pediatric blunt splenic injury became the standard of care in the late 1980s. The extent to which this practice has been adopted in both trauma centers and nontrauma hospitals has been investigated sporadically. Several studies have demonstrated significant variations in practice patterns; however, most published studies capture only a selective population over

2005 Pediatrics

2779. Splenic injury after colonoscopy. (Abstract)

difficulties during the colonoscopy had been reported in four patients. All the patients had a symptom-free interval after the colonoscopy, ranging from 4 hours to 7 days, before presenting with signs of splenic injury. In all cases the spleen was torn, and the amount of blood in the peritoneal cavity ranged from 1500 mL to 5000 mL. Two patients died postoperatively. The number of cases reported after 2000 indicates that this potentially lethal complication might be more common than was previously assumed (...) Splenic injury after colonoscopy. Splenic injury is a rare and serious complication of colonoscopy. The most likely mechanism is tension on the splenocolic ligament and adhesions. Eight cases were identified among claims for compensation submitted to the Danish Patient Insurance Association during the period 1992-2006, seven of which were reported after 2000. The total number of colonoscopies in Denmark in 2004 was 39 067. Seven of the eight patients were aged 65 years or over. Loops causing

2007 Endoscopy

2780. Boarder belly: splenic injuries resulting from ski and snowboarding accidents. Full Text available with Trip Pro

for female snowboarders (P = 0.002). By contrast, no gender differences were observed for skiers. Snowboarders admitted to hospital with a splenic injury were significantly younger, more likely to present with an isolated injury and to required a shorter hospital stay, as compared to skiers.The risk of sustaining an injury of the spleen resulting from blunt abdominal trauma while snowboarding is significantly greater than the risk while downhill skiing. Male snowboarders have a significantly higher risk (...) Boarder belly: splenic injuries resulting from ski and snowboarding accidents. Snowboarding has increased in popularity worldwide, with an associated increase in injuries suffered by its participants with a significant proportion of these injuries being severe. We sought to understand the risk of sustaining a splenic injury in snowboarders as compared to skiers, and whether there are noteworthy differences in their characteristics at hospital admission.A 10-year retrospective review

2005 Emergency medicine Australasia

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