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Splenic Injury

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41. Interventional radiology versus surgical management on mortality for splenic injuries: a systematic review and meta-analysis

Interventional radiology versus surgical management on mortality for splenic injuries: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne

2018 PROSPERO

42. Splenic Injury

, Injury of Spleen , Ruptured Spleen , Splenic Rupture From Related Chapters II. Grading: AAST CT Grade for Splenic Injury Precautions May not accurately correlate with surgical findings Does not consistently predict the need for surgical intervention Grade 1 Subcapsular hematoma <10% surface area OR Splenic <1 cm depth into parenchyma Grade 2 Subcapsular hematoma 10-50% surface area OR Splenic 1-3 cm depth into parenchyma (not involving trabecular vessels) Grade 3 Subcapsular hematoma >50% surface (...) 210196007 , 157342001 , 269157005 , 23589004 English Injury to spleen , Injury to spleen NOS , injury of spleen , injury of spleen (diagnosis) , Splenic injury , Unspecified injury of spleen , Injury of spleen, unspecified , injury splenic , injury to spleen , Injury;spleen , injury spleen , injuries splenic , splenic injury , injuries spleen , spleen injury , Injury to spleen NOS (disorder) , Injury of spleen , Injury of spleen (disorder) , injury; spleen , spleen; injury , Injury of spleen, NOS

2018 FP Notebook

43. How Does the Severity of Injury Vary between Motorcycle and Automobile Accident Victims Who Sustain High-Grade Blunt Hepatic and/or Splenic Injuries? Results of a Retrospective Analysis Full Text available with Trip Pro

How Does the Severity of Injury Vary between Motorcycle and Automobile Accident Victims Who Sustain High-Grade Blunt Hepatic and/or Splenic Injuries? Results of a Retrospective Analysis High-grade blunt hepatic and/or splenic injuries (BHSI) remain a great challenge for trauma surgeons. The main aim of this study was to investigate the characteristics, mortality rates, and outcomes of high-grade BHSI in motorcyclists and car occupants hospitalized for treatment of traumatic injuries in a Level (...) I trauma center in southern Taiwan.High-grade BHSI are defined as grade III-VI blunt hepatic injuries and grade III-V blunt splenic injuries. This retrospective study reviewed the data of 101 motorcyclists and 32 car occupants who experienced a high-grade BHSI from 1 January 2011 to 31 December 2013. Two-sided Fisher's exact or Pearson's chi-square tests were used to compare categorical data, unpaired Student's t-test was used to analyze normally distributed continuous data, and Mann-Whitney's U

2016 International journal of environmental research and public health

44. Unusual Complications From Babesia Infection: Splenic Infarction and Splenic Rupture in Two Separate Patients. (Abstract)

in patients with splenic injuries and without obvious traditional risk factors.Copyright © 2018 Elsevier Inc. All rights reserved. (...) Unusual Complications From Babesia Infection: Splenic Infarction and Splenic Rupture in Two Separate Patients. Babesiosis is a zoonotic parasitic infection transmitted by the tick, Ixodes scapularis. Splenic infarct and rupture are infrequent complications of Babesia parasitemia, and have not been previously reported in the emergency medicine literature.We present two separate cases seen within 1 month at our institution: a case of splenic rupture and another case of splenic infarction due

2018 Journal of Emergency Medicine

45. 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

46. Natural history of splenic vascular abnormalities after blunt injury: A Western Trauma Association multicenter trial. (Abstract)

Natural history of splenic vascular abnormalities after blunt injury: A Western Trauma Association multicenter trial. Following blunt splenic injury, there is conflicting evidence regarding the natural history and appropriate management of patients with vascular injuries of the spleen such as pseudoaneurysms or blushes. The purpose of this study was to describe the current management and outcomes of patients with pseudoaneurysm or blush.Data were collected on adult (aged ≥18 years) patients (...) with blunt splenic injury and a splenic vascular injury from 17 trauma centers. Demographic, physiologic, radiographic, and injury characteristics were gathered. Management and outcomes were collected. Univariate and multivariable analyses were used to determine factors associated with splenectomy.Two hundred patients with a vascular abnormality on computed tomography scan were enrolled. Of those, 14.5% were managed with early splenectomy. Of the remaining patients, 59% underwent angiography

2017 The journal of trauma and acute care surgery Controlled trial quality: uncertain

47. 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

48. 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

49. 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

50. Distal embolization versus combined embolization techniques for blunt splenic injuries: comparison of the efficacy and complications Full Text available with Trip Pro

Distal embolization versus combined embolization techniques for blunt splenic injuries: comparison of the efficacy and complications Comparable failure rates of distal or proximal transcatheter arterial embolization (TAE) techniques for blunt splenic injuries have been reported. This study is to investigate the efficacy and complication of combining both TAE techniques. We included 26 patients of blunt splenic injuries for TAE therapy and randomized them into distal TAE and combined TAE groups (...) . They were considered failures in distal TAE group as opposed to all successes in combined TAE group. The risk difference of failure of distal TAE was 17.6%. None developed post-TAE splenic abscess, massive splenic infarct or pancreatitis. The mean splenic infarct volume of distal TAE (10.9%) versus combined TAE groups (6.6%) was not significant (p = 0.481). Combined TAE is effective and safe to decrease the failure rates of non-operative management for blunt splenic injuries.

2017 Oncotarget Controlled trial quality: uncertain

51. Calf Spleen Extractive Injection protects mice against cyclophosphamide-induced hematopoietic injury through G-CSF-mediated JAK2/STAT3 signaling Full Text available with Trip Pro

Calf Spleen Extractive Injection protects mice against cyclophosphamide-induced hematopoietic injury through G-CSF-mediated JAK2/STAT3 signaling Calf Spleen Extractive Injection (CSEI), extracted from the spleen of healthy cows (within 24 hours of birth), is a small-peptide-enriched extraction and often used as an ancillary agent in cancer therapy. This study evaluated the hematopoietic function of CSEI and its underlying mechanisms, principally in CHRF, K562 cells, BMNCs and a mouse model (...) of cyclophosphamide (CTX)-induced hematopoietic suppression. CSEI promoted the proliferation and differentiation of CHRF and K562 cells, activated hematopoietic- and proliferation-related factors RSK1p90, ELK1 and c-Myc, and facilitated the expression of differentiation- and maturation-related transcription factors GATA-1, GATA-2. In the mice with hematopoietic suppression, 3 weeks of CSEI administration enhanced the bodyweights and thymus indices, suppressed the spleen indices and strongly elevated

2017 Scientific reports

52. Expression of pro-inflammatory genes in lesions, spleens and blood neutrophils after burn injuries in mice treated with silver sulfodiazine Full Text available with Trip Pro

Expression of pro-inflammatory genes in lesions, spleens and blood neutrophils after burn injuries in mice treated with silver sulfodiazine It is now supposed that cytokines released during the burn injuries have a great impact on the immunological and pathological responses after the burn. The main objective of this study was to investigate the expression of some pro-inflammatory genes in the wound, spleen and blood neutrophils during the healing process of burn wounds in a murine model.The (...) expression of ten pro-inflammatory genes were examined in wounds, spleens and blood neutrophils of mice with burn injuries treated with either silver sulfodiazine or phosphate-buffered saline (PBS) using RT-PCR at the end of the first and second weeks after injuries.None of the pro-inflammatory genes were expressed in the skin, spleen and blood neutrophils of healthy mice. In the group control, IL-12P35, IL-12P40, CCR5, IL-1β and IFN-γ were expressed in the spleen and blood neutrophils in the first week

2017 Iranian journal of basic medical sciences

53. Splenic Injury Following Endoscopic Retrograde Cholangiopancreatography: A Case Report and Literature Review Full Text available with Trip Pro

Splenic Injury Following Endoscopic Retrograde Cholangiopancreatography: A Case Report and Literature Review Splenic injury following endoscopy is a rare but potentially fatal complication. While this has been found to occur more frequently after colonoscopy, splenic injury following endoscopic retrograde cholangiopancreatography (ERCP) remains highly uncommon since its first reported case in 1989. Indeed, there have been only 19 such cases reported in the English, German, and Spanish (...) literature collectively over the past 27 years. We report on a 59-year-old woman who developed a peri-splenic haematoma diagnosed on abdominal computed tomography the day following ERCP and stenting for Mirizzi syndrome. The patient was treated conservatively and made a full recovery. We reviewed all cases of post-ERCP splenic injuries reported to date and discuss the published opinions on the likely mechanism of injury, predisposing factors, presenting features, investigation, and treatment options

2017 Case reports in gastroenterology

54. 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

55. Inhibition of spleen tyrosine kinase reduces renal allograft injury in a rat model of acute antibody-mediated rejection in sensitized recipients. (Abstract)

Inhibition of spleen tyrosine kinase reduces renal allograft injury in a rat model of acute antibody-mediated rejection in sensitized recipients. Organ transplantation into sensitized patients with preexisting donor-specific antibodies (DSA) is very challenging. Spleen tyrosine kinase (Syk) promotes leukocyte recruitment and activation via signaling through various cell surface receptors. We investigated whether a selective Syk inhibitor (GS-492429) could suppress antibody-mediated rejection (...) (AMR) in a rat model of AMR in sensitized recipients.Recipient Lewis rats (RT1) were immunized with donor (Dark Agouti, RT1) spleen cells (day -5). Recipients underwent bilateral nephrectomy and orthotopic renal transplantation (day 0). Cellular rejection was minimized by tacrolimus treatment from day -1. Groups received GS-492429 (30 mg/kg, twice a day) (n = 11) or vehicle (n = 12) from 1 hour before transplantation until being killed on day 3.Vehicle-treated recipients developed graft dysfunction

2017 Transplantation

56. Circulating IL-6 upregulates IL-10 production in splenic CD4<sup>+</sup> T cells and limits acute kidney injury-induced lung inflammation. Full Text available with Trip Pro

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

57. The spleen as a bidirectional signal transducer in acute kidney injury. Full Text available with Trip Pro

The spleen as a bidirectional signal transducer in acute kidney injury. In acute kidney injury models, the lung is damaged through an interleukin-6-dependent inflammatory response. Clinically, development of lung injury requiring mechanical ventilation markedly increases in-hospital acute kidney injury mortality. Andres-Hernando et al. demonstrate that the spleen coordinates interleukin-6-dependent interleukin-10 production, which lessens lung injury during experimental acute kidney injury (...) . This study highlights the beneficial influence of the spleen on the lung, and dovetails with other recent publications, to demonstrate the integral role of the spleen in acute kidney injury.Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

2017 Kidney International

58. Interventional Radiology service provision and practice for the management of traumatic splenic injury across the Regional Trauma Networks of England. (Abstract)

Interventional Radiology service provision and practice for the management of traumatic splenic injury across the Regional Trauma Networks of England. The management of blunt splenic injuries (BSI) has evolved toward strategies that avoid splenectomy. There is growing adoption of interventional radiology (IR) techniques in non-operative management of BSI, with evidence suggesting a corresponding reduction in emergency laparotomy requirements and increased splenic preservation rates. Currently (...) there are no UK national guidelines for the management of blunt splenic injury. This may lead to variations in management, despite the reorganisation of trauma services in England in 2012.A survey was distributed through the British Society of Interventional Radiologists to all UK members aiming to identify availability of IR services in England, radiologists' practice, and attitudes toward management of BSI.116 responses from respondents working in 23 of the 26 Regional Trauma Networks in England were

2017 Injury

59. Overall Splenectomy Rates Stable Despite Increasing Usage of Angiography in the Management of High-grade Blunt Splenic Injury. Full Text available with Trip Pro

Overall Splenectomy Rates Stable Despite Increasing Usage of Angiography in the Management of High-grade Blunt Splenic Injury. The purpose of this study was to understand the contemporary trends of splenectomy in blunt splenic injury (BSI) and to determine if angiography and embolization (ANGIO) may be impacting the splenectomy rate.The approach to BSI has shifted to increasing use of nonoperative management, with a greater reliance on ANGIO. However, the impact ANGIO has on splenic salvage (...) remains unclear with little contemporary data.The National Trauma Data Bank was used to identify patients 18 years and older with high-grade BSI (Abbreviated Injury Scale >II) treated at Level I or II trauma centers between 2008 and 2014. Primary outcomes included yearly rates of splenectomy, which was defined as early if performed within 6 hours of ED admission and delayed if greater than 6 hours, ANGIO, and mortality. Trends were studied over time with hierarchical regression models.There were

2017 Annals of Surgery

60. Hypotension and the need for transfusion in pediatric blunt spleen and liver injury: An ATOMAC+ prospective study. (Abstract)

Hypotension and the need for transfusion in pediatric blunt spleen and liver injury: An ATOMAC+ prospective study. Children with blunt liver or spleen injury (BLSI) requiring early transfusion may present without hypotension despite significant hypovolemia. This study sought to determine the relationship between early transfusion in pediatric BLSI and hypotension.Secondary analysis of a 10-institution prospective observational study was performed of patients 18years and younger presenting (...) with BLSI. Patients with central nervous system (CNS) injury were excluded. Children receiving blood transfusion within 4h of injury were evaluated. Time to first transfusion, vital signs, and physical exams were analyzed. Patients with hypotension were compared to those without hypotension.Of 1008 patients with BLSI, 47 patients met inclusion criteria. 22 (47%) had documented hypotension. There was no statistical difference in median time to first transfusion for those with or without hypotension (2h

2017 Journal of Pediatric Surgery

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