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Splenic Injury

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21. Endoscopic Retrograde Cholangiopancreatography–Induced Splenic Injury in a Patient With Sleeve Gastrectomy Full Text available with Trip Pro

Endoscopic Retrograde Cholangiopancreatography–Induced Splenic Injury in a Patient With Sleeve Gastrectomy Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive procedure with significant complications. Splenic hematoma is an extremely rare but known complication following ERCP that has been increasingly reported in the past several years. We report the case of a 44-year-old patient with a history of sleeve gastrectomy who underwent an ERCP that was complicated by both acute (...) pancreatitis and splenic hematoma. She was managed conservatively under close monitoring in the intensive care unit. Clinicians should be aware of this potentially life-threatening complication to make a prompt diagnosis and begin early appropriate management.

2018 Journal of investigative medicine high impact case reports

22. Splenectomy proportions are still high in low-grade traumatic splenic injury Full Text available with Trip Pro

Splenectomy proportions are still high in low-grade traumatic splenic injury The spleen is the most vulnerable organ in blunt abdominal trauma. Spleen-preserving treatments are non-operative management with or without splenic angioembolization, partial splenectomy, and splenorrhaphy. The aim of the present study was to determine the rate of SPTs and to evaluate the usefulness of Injury Severity Score after traumatic splenic injury.We searched our institution's database between May 2012 (...) after nonoperative management. Exitus rates were 5/30 (15.1%) and 0/3 in the total splenectomy and spleen preserving treatment groups, respectively. Of the 18 hemodynamically stable patients, only 2 (11.1%) had spleen preserving treatment. Of the 19 patients with grade I-III splenic injury, only 3 (15.8%) had spleen preserving treatment. For academic and non-academic surgeons, spleen preserving treatment rates were 3/11 (27.3%) and 0/22 (0%), respectively (p<0.05). Injury severity score and mean

2018 Turkish Journal of Surgery

23. Spleen-derived classical monocytes mediate lung ischemia-reperfusion injury through IL-1β Full Text available with Trip Pro

Spleen-derived classical monocytes mediate lung ischemia-reperfusion injury through IL-1β Ischemia-reperfusion injury, a form of sterile inflammation, is the leading risk factor for both short-term mortality following pulmonary transplantation and chronic lung allograft dysfunction. While it is well recognized that neutrophils are critical mediators of acute lung injury, processes that guide their entry into pulmonary tissue are not well understood. Here, we found that CCR2+ classical (...) monocytes are necessary and sufficient for mediating extravasation of neutrophils into pulmonary tissue during ischemia-reperfusion injury following hilar clamping or lung transplantation. The classical monocytes were mobilized from the host spleen, and splenectomy attenuated the recruitment of classical monocytes as well as the entry of neutrophils into injured lung tissue, which was associated with improved graft function. Neutrophil extravasation was mediated by MyD88-dependent IL-1β production

2018 The Journal of clinical investigation

24. Recent trends in 30-day mortality in patients with blunt splenic injury: A nationwide trauma database study in Japan. Full Text available with Trip Pro

Recent trends in 30-day mortality in patients with blunt splenic injury: A nationwide trauma database study in Japan. Splenic injury frequently occurs after blunt abdominal trauma; however, limited epidemiological data regarding mortality are available. We aimed to investigate mortality rate trends after blunt splenic injury in Japan.We retrospectively identified 1,721 adults with blunt splenic injury (American Association for the Surgery of Trauma splenic injury scale grades III-V) from (...) /splenorrhaphy, adjusting for known potential confounders and for within-hospital clustering using generalised estimating equation.Over time, there was a significant decrease in 30-day mortality after splenic injury (p < 0.01). Logistic regression analysis revealed that mortality significantly decreased over time (from phase I to phase II, odds ratio: 0.39, 95% confidence interval: 0.22-0.67; from phase I to phase III, odds ratio: 0.34, 95% confidence interval: 0.19-0.62) for the overall cohort. While the 30

2017 PLoS ONE

25. Nonoperative Management of Blunt Splenic Trauma in Patients with Traumatic Brain Injury: Feasibility and Outcomes. (Abstract)

). We hypothesized that the presence of a TBI in patients with blunt splenic injury would lead to a higher risk of FNOM.Patients with blunt splenic injury were selected from the National Trauma Data Bank research datasets from 2007 to 2011. TBI was defined as AIS head ≥ 3 and FNOM as patients who underwent a spleen-related operation after 2 h from admission. TBI patients were compared to those without head injury. The primary outcome was FNOM.Of 47,713 patients identified, 41,436 (86.8%) underwent (...) Nonoperative Management of Blunt Splenic Trauma in Patients with Traumatic Brain Injury: Feasibility and Outcomes. Preventing secondary insult to the brain is imperative following traumatic brain injury (TBI). Although TBI does not preclude nonoperative management (NOM) of splenic injuries, development of hypotension in this setting may be detrimental and could therefore lead trauma surgeons to a lower threshold for operative intervention and a potentially higher risk of failure of NOM (FNOM

2018 World Journal of Surgery

26. Pediatric trauma center verification improves quality of care and reduces resource utilization in blunt splenic injury. Full Text available with Trip Pro

Pediatric trauma center verification improves quality of care and reduces resource utilization in blunt splenic injury. We sought to evaluate value impact of transition from an adult trauma center treating children (ATC) to a verified pediatric trauma center (PTC) in children with blunt splenic injury (BSI).Children with BSI from FY 2005 to FY 2017 were extracted from the hospital trauma registry. February 2009 distinguished "ATC" treated children from "PTC" treated children. Cohorts were (...) subcategorized into "isolated injury" and "multisystem injury". Quality and financial characteristics were statistically compared. Analysis of covariance was used to evaluate changes in quality and financial trends over the transition period. A multiple linear regression was performed to identify variables independently predictive of hospital and professional charges.126 children with BSI were identified (ATC, n = 56; PTC, n = 70). Splenic procedure rates and hospital charges decreased. Quality and cost

2018 Journal of Pediatric Surgery

27. Splenic Injury: An Unusual Complication of Colonoscopy Full Text available with Trip Pro

Splenic Injury: An Unusual Complication of Colonoscopy 29363661 2018 12 12 2018 12 12 2542-5641 131 3 2018 Feb 05 Chinese medical journal Chin. Med. J. Splenic Injury: An Unusual Complication of Colonoscopy. 372-373 10.4103/0366-6999.223864 Ungprasert Patompong P Department of Internal Medicine, Bassett Medical Center, Cooperstown, New York 13326, USA. Jaruvongvanich Veeravich V Department of Internal Medicine, University of Hawaii, Honolulu, Hawaii 96795, USA. eng Case Reports Letter China (...) Chin Med J (Engl) 7513795 0366-6999 IM Colonoscopy adverse effects Humans Spleen injuries 2018 1 25 6 0 2018 1 25 6 0 2018 12 13 6 0 ppublish 29363661 ChinMedJ_2018_131_3_372_223864 10.4103/0366-6999.223864 PMC5798067 Ochsner J. 2011 Fall;11(3):276-81 21960762 Dig Dis Sci. 2008 Apr;53(4):892-8 17934832 J Gastrointest Surg. 2012 Jun;16(6):1225-34 22450952 Radiology. 1987 Jan;162(1 Pt 1):69-71 3786787 South Med J. 2011 Jul;104(7):515-20 21886052

2018 Chinese medical journal

28. Delayed Splenic Rupture Resulting in Massive Intraperitoneal Hemorrhage Post Ambulatory-Related Injury Full Text available with Trip Pro

Delayed Splenic Rupture Resulting in Massive Intraperitoneal Hemorrhage Post Ambulatory-Related Injury Delayed splenic rupture, once thought to be unusual, but now growing in incidence, is an issue that could potentiate severe morbidity and mortality to patients, regardless of the severity of the trauma. This case report presents one instance of delayed splenic rupture following minor trauma and discusses the need for further investigation in the management of this condition. A middle-aged (...) after delayed splenic rupture, even with minor traumatic events. Current guidelines suggest nonoperative management of splenic injury in stable patients with low-grade splenic injuries after blunt abdominal trauma. However, with the varied presentation and difficulty in the assessment of delayed splenic rupture, patients may be exposed to undue risks with current recommendations on the management of splenic injuries. Further research is needed to find the best practice in managing, and possibly

2018 Cureus

29. Patient, Procedure, and Endoscopist Risk Factors for Perforation, Bleeding, and Splenic Injury After Colonoscopies. Full Text available with Trip Pro

Patient, Procedure, and Endoscopist Risk Factors for Perforation, Bleeding, and Splenic Injury After Colonoscopies. We investigated perforations, bleeding, and splenic injuries after screening or diagnostic colonoscopies to identify patient-, procedure-, endoscopist-, and facility-associated risk factors.We analyzed data from the SNIIRAM-PMSI national claims databases in France. A total of 4,088,799 patients, 30 years or older, undergoing a first screening or diagnostic colonoscopy from 2010 (...) through 2015 were identified. Rates of severe adverse events (SAEs) were estimated using stringent and broad definitions. Risk factors associated with perforations and major bleeding were estimated using multilevel logistic regression models, adjusted for patient, colonoscopy, and endoscopist characteristics.Perforation rates ranged from 3.5 (stringent definition) to 7.3 (broad definition) per 10,000 procedures, bleeding rates ranged from 6.5 to 23.1 per 10,000 procedures, and splenic injury rates

2018 Clinical Gastroenterology and Hepatology

30. Long-term sustainability of Washington State's quality improvement initiative for the management of pediatric spleen injuries. (Abstract)

Long-term sustainability of Washington State's quality improvement initiative for the management of pediatric spleen injuries. Initial results of Washington State's quality improvement initiative addressing the management of blunt traumatic pediatric spleen injuries were published in 2008. In this update, we evaluated whether these effects were sustained over time.Data from the Washington Trauma Registry for years 1999-2001 (pre-intervention), 2003-2005 (post-intervention), and 2012-2014 (...) (follow-up) were used in a retrospective cohort study. Children between ages 0 to 14 years who were hospitalized with a traumatic blunt spleen injury were included. Multivariable logistic regression was used to account for patient, injury, and hospital characteristics.Overall, splenectomies continued to be less common with 8.3% of pediatric patients receiving splenectomies in the follow-up period compared with 14.3% and 7.2% in the preintervention and post-intervention periods (p = 0.034). After

2018 Journal of Pediatric Surgery

31. Splenic Injury, Blunt, Selective Nonoperative Management of

in mortality of these injuries. [1] Pachter et al., [2] in 1998, showed that 65% of all blunt splenic injuries and could be managed nonoperatively with minimal transfusions, morbidity, or mortality, with a success rate of 98%. These issues were first addressed by the Eastern Association for the Surgery of Trauma (EAST) in the Practice Management Guidelines for Non-operative Management of Blunt Injury to the Liver and Spleen published online in 2003. [3] Since that time, a large volume of literature (...) normal blunt abdominal trauma patient without peritonitis, an abdominal CT scan with intravenous contrast should be performed to identify and assess the severity of injury to the spleen. Angiography should be considered for patients with American Association for the Surgery of Trauma (AAST) grade of greater than III injuries, presence of a contrast blush, moderate hemoperitoneum, or evidence of ongoing splenic bleeding. Nonoperative management of splenic injuries should only be considered

2012 Eastern Association for the Surgery of Trauma

32. Circulating IL-6 upregulates IL-10 production in splenic CD4<sup>+</sup> T cells and limits acute kidney injury-induced lung inflammation. (Abstract)

Circulating IL-6 upregulates IL-10 production in splenic CD4+ T cells and limits acute kidney injury-induced lung inflammation. Although it is well established that acute kidney injury (AKI) is a proinflammatory state, little is known about the endogenous counter-inflammatory response. IL-6 is traditionally considered a pro-inflammatory cytokine that is elevated in the serum in both human and murine AKI. However, IL-6 is known to have anti-inflammatory effects. Here we sought (...) to investigate the role of IL-6 in the counter-inflammatory response after AKI, particularly in regard to the anti-inflammatory cytokine IL-10. Ischemic AKI was induced by bilateral renal pedicle clamping. IL-10-deficient mice had increased systemic and lung inflammation after AKI, demonstrating the role of IL-10 in limiting inflammation after AKI. We then sought to determine whether IL-6 mediates IL-10 production. Wild-type mice with AKI had a marked upregulation of splenic IL-10 that was absent in IL-6

2017 Kidney International

33. National Readmission Patterns of Isolated Splenic Injuries Based on Initial Management Strategy. Full Text available with Trip Pro

National Readmission Patterns of Isolated Splenic Injuries Based on Initial Management Strategy. Options for managing splenic injuries have evolved with a focus on nonoperative management. Long-term outcomes, such as readmissions and delayed splenectomy rate, are not well understood.To describe the natural history of isolated splenic injuries in the United States and determine whether patterns of readmission were influenced by management strategy.The Healthcare Cost and Utilization Project's (...) Nationwide Readmission Database is an all-payer, all-ages, longitudinal administrative database that provides data on more than 35 million weighted US discharges yearly. The database was used to identify patients with isolated splenic injuries and the procedures that they received. Adult patients with isolated splenic injuries admitted from January 1 through June 30, 2013, and from January 1 through June 30, 2014, were included. Those who died during the index hospitalization or who had an additional

2017 JAMA surgery

34. A comparison of the management of blunt splenic injury in children and young people-A New South Wales, population-based, retrospective study. (Abstract)

A comparison of the management of blunt splenic injury in children and young people-A New South Wales, population-based, retrospective study. The importance and safety of non-operative management (NOM) of Blunt Splenic Injury (BSI) has been established in children and adults over recent decades. However, studies have shown higher operation rates in adults. There is international evidence that when children are managed in adult centres, operation rates are higher while adolescents in paediatric (...) included age over 16 (OR 2.82, 95%CI 2.10-3.81), splenic injury severity, associated thoracic, liver, pancreatic and hollow viscus injury, and blood transfusion.While Paediatric Surgeons have wholeheartedly adopted non-operative management, away from paediatric centres, it is possible children and young people in NSW are undergoing operation unnecessarily. Further evaluation of the surgeon attitudes and institutional factors involved in the management of injured children and young people within

2017 Injury

35. Long-Term Follow-Up After Non-operative Management of Blunt Splenic and Liver Injuries: A Questionnaire-Based Survey. (Abstract)

Long-Term Follow-Up After Non-operative Management of Blunt Splenic and Liver Injuries: A Questionnaire-Based Survey. Non-operative management (NOM) of blunt splenic or liver injuries (solid organ injury, SOI) has become the standard of care in hemodynamically stable patients. However, the incidence of long-term symptoms in these patients is currently not known. The aim of this study was to assess long-term symptoms in patients undergoing successful NOM (sNOM) for SOI.Long-term posttraumatic (...) of recurrent infections was found in patients with splenic injuries (15.9 vs. 2.8%, p = 0.067).A third of patients with blunt SOI undergoing sNOM reported long-term abdominal symptoms. Younger age was associated with chronic abdominal symptoms. More studies are warranted to investigate long-term outcomes immunologic sequelae in patients after sNOM for SOI.

2017 World Journal of Surgery

36. Clinical features and outcomes of blunt splenic injury in children: A retrospective study in a single institution in China. Full Text available with Trip Pro

Clinical features and outcomes of blunt splenic injury in children: A retrospective study in a single institution in China. Although the spleen is the most commonly injured intra-abdominal organ after blunt trauma, there are limited data available in China. The objectives of this study were to investigate the clinical features and determine the risk factors for operative management (OM) in children with blunt splenic injury (BSI).A review of the medical records of children diagnosed with BSI (...) between January 2010 and September 2016 at West China Hospital of Sichuan University was performed.A total of 101 patients diagnosed with BSI were recruited, including 76 patients transferred from other hospitals. The male-to-female ratio was 2.06:1, with a mean age of 7.8 years old. The most common injury season was summer and the most common injury mechanism was road traffic accidents. Sixty-eight patients suffered multiple injuries. Thirty-four patients received blood transfusions. Two patients

2017 Medicine

37. Conservative Management of Combined Pleural and Splenic Injury During Percutaneous Nephrostolithotomy Full Text available with Trip Pro

Conservative Management of Combined Pleural and Splenic Injury During Percutaneous Nephrostolithotomy Splenic injuries related to percutaneous nephrostolithotomy (PCNL) are infrequent. Herein, we report a combined splenic and pleural injury incurred during PCNL along with radiographic images documenting the complication. A review of management techniques for similar injuries is included.

2016 Journal of endourology case reports

38. Epidemiology and management of splenic injury: An analysis of a Chinese military registry Full Text available with Trip Pro

Epidemiology and management of splenic injury: An analysis of a Chinese military registry In China, there have been few meta-analyses of the epidemiology and management of splenic injury. Due to the success of Chinese military hospitals in the domestic treatment of splenic injury, the present study conducted a systematic review of such cases, identifying a high occurrence rate of splenic trauma, as well as a number of strategies of managing splenic injury in China. Data were collected from (...) sixteen Chinese military hospitals between July 2000 and March 2009, and retrospectively reviewed. It was observed that between July 2000 and March 2009 a total of 7,807 patients (84.32% male and 15.68% female) with splenic injury were admitted to hospital. The mean duration of hospital stay was 17.9±18.6 days and the gender distribution of splenic injury over the successive years did not differ significantly (P>0.05, c=0.034). However, there was a significant difference in the gender distribution

2017 Experimental and therapeutic medicine

39. Shock due to Splenic Injury after Colonoscopy Full Text available with Trip Pro

Shock due to Splenic Injury after Colonoscopy Colonoscopy is a common and increasingly performed procedure. It is used both as a diagnostic and therapeutic modality. Splenic injury after colonoscopy is a rare, yet life-threatening complication, most often caused by traction on the splenocolic ligament or excessive manipulation during the procedure. Although non-operative treatment is preferred upon splenic injury, early surgical or radiological intervention may be necessary in specific cases (...) , patients with abdominal pain and/or shock should be checked for complications such as splenic injury and colon perforation.

2017 Case reports in gastroenterology

40. Splenic glucocorticoid resistance following psychosocial stress requires physical injury Full Text available with Trip Pro

Splenic glucocorticoid resistance following psychosocial stress requires physical injury Mice exposed to chronic subordinate colony housing (CSC) stress show glucocorticoid (GC) resistance of in vitro lipopolysaccharide (LPS)-stimulated splenocytes, increased anxiety and colitis. Similar effects were reported in wounded mice exposed to social disruption (SDR). Here we show that CSC exposure induced GC resistance in isolated and in vitro LPS-stimulated, but not unstimulated, splenocytes (...) , and these effects were absent when CD11b+ splenocytes were depleted. Moreover, re-active coping behaviour during CSC correlated with the attacks and bites received by the resident, which in turn highly correlated with the dimension of splenic GC resistance, as with basal and LPS-induced in vitro splenocyte viability. Importantly, social stress promoted spleen cell activation, independent of bite wounds or CD11b+/CD11b- cell phenotype, whereas GC resistance was dependent on both bite wounds and the presence

2017 Scientific reports

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