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Splenic Injury

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61. Traumatic Splenic Injury and Management (SPLENIQ Study)

: literature search and conducting the retrospective study and analyses. Years 1-3: inclusion prospective study and follow-up of patients. Year 4: finishing follow-up data collection and analysing. Condition or disease Intervention/treatment Quality of Life Spleen Injury Trauma Splenic Artery Embolization Other: Questionnaires Diagnostic Test: MRI abdomen Study Design Go to Layout table for study information Study Type : Observational Actual Enrollment : 106 participants Observational Model: Cohort Time (...) Perspective: Prospective Official Title: Traumatic Splenic Injury and Management (SPLENIQ Study) Quality of Life and Clinical Outcomes of Treatment for Splenic Injury After Trauma Actual Study Start Date : March 1, 2017 Estimated Primary Completion Date : December 31, 2019 Estimated Study Completion Date : December 31, 2019 Groups and Cohorts Go to Group/Cohort Intervention/treatment Non-Operative Management (NOM)/Observational Patients "treated" observationally for (traumatic) spleen injury. Other

2017 Clinical Trials

62. Splenic Injury Embolization

objective is to compare the failure rate due to splenic bleeding between the patients undergoing pre-emptive SAE as part of NOM and the patients not undergoing SAE. The primary endpoint is the proportion of subjects failing NOM due to spleen related bleeding within 7 days of injury. All analyses will be based on an intention to treat analysis. Secondary Outcome Measures : Delayed bleeding episode [ Time Frame: 6-12 weeks ] Incidence. Delayed bleeding episode is defined as hemodynamically unstable (...) Splenic Injury Embolization Splenic Injury Embolization - the Question About NOM (SInE Qua NOM) - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Splenic Injury Embolization - the Question About NOM (SInE Qua

2017 Clinical Trials

63. 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

64. A Novel Case of Splenic Injury After Shockwave Lithotripsy. (Abstract)

A Novel Case of Splenic Injury After Shockwave Lithotripsy. Emergency departments (EDs) are gateways for patients presenting after minor surgical procedures, particularly shockwave lithotripsy. Complications include renal and extrarenal tissue injuries, with the latter having potentially serious consequences if not detected early.We describe a 70-year-old male presenting to the ED for syncope. The patient underwent shockwave lithotripsy (SWL) for left kidney stones 1 day prior. Upon initial (...) evaluation, the patient had normal vital signs and a normal physical examination, without complaints of abdominal pain. Close observation and regular patient re-evaluation led to the diagnosis of life-threatening injuries that included splenic rupture. Although this is a rare complication of SWL, with only eight published cases found in the literature, the patient's initial presentation of syncope without complaints of abdominal pain presented a unique diagnostic challenge. WHY SHOULD AN EMERGENCY

2017 Journal of Emergency Medicine

65. Association between pediatric blunt splenic injury volume and the splenectomy rate. (Abstract)

Association between pediatric blunt splenic injury volume and the splenectomy rate. While pediatric trauma centers are shown to have lower splenectomy rate as compared to adult trauma centers, it remains unknown whether other institutional factors such as case volumes would have an impact on the splenectomy rate in pediatric blunt splenic injury (BSI).Pediatric patients who sustained BSI were identified from the National Trauma Data Bank 2007-2014. A hierarchical logistic regression model (...) -0.83, 0.44-0.95 for Groups 3 and 4, respectively) with an additional survival benefit in Group 4 (OR 0.452, 95%CI 0.257-0.793) when compared to the lowest volume centers (Group 1).Higher pediatric BSI case volume was associated with lower splenectomy rate with an additional survival benefit. Trauma centers' volume in pediatric BSI may be an important factor for the improved splenic preservation.Retrospective comparative study, Level III.Copyright © 2017 Elsevier Inc. All rights reserved.

2017 Journal of Pediatric Surgery

66. 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

67. The spleen as an extramedullary source of inflammatory cells responding to acetaminophen-induced liver injury Full Text available with Trip Pro

The spleen as an extramedullary source of inflammatory cells responding to acetaminophen-induced liver injury Macrophages have been shown to play a role in acetaminophen (APAP)-induced hepatotoxicity, contributing to both pro- and anti-inflammatory processes. In these studies, we analyzed the role of the spleen as an extramedullary source of hepatic macrophages. APAP administration (300mg/kg, i.p.) to control mice resulted in an increase in CD11b(+) infiltrating Ly6G(+) granulocytic and Ly6G (...) (-) monocytic cells in the spleen and the liver. The majority of the Ly6G(+) cells were also positive for the monocyte/macrophage activation marker, Ly6C, suggesting a myeloid derived suppressor cell (MDSC) phenotype. By comparison, Ly6G(-) cells consisted of 3 subpopulations expressing high, intermediate, and low levels of Ly6C. Splenectomy was associated with increases in mature (F4/80(+)) and immature (F4/80(-)) pro-inflammatory Ly6C(hi) macrophages and mature anti-inflammatory (Ly6C(lo)) macrophages

2016 Toxicology and applied pharmacology

68. Organ crushing tackle: pancreatic, bowel and splenic artery injury from blunt abdominal trauma playing rugby union Full Text available with Trip Pro

Organ crushing tackle: pancreatic, bowel and splenic artery injury from blunt abdominal trauma playing rugby union 26786533 2016 12 13 2018 11 13 1757-790X 2016 2016 Jan 19 BMJ case reports BMJ Case Rep Organ crushing tackle: pancreatic, bowel and splenic artery injury from blunt abdominal trauma playing rugby union. 10.1136/bcr-2015-214124 bcr2015214124 Moore Timothy T NSW Health, Manly, New South Wales, Australia. eng Case Reports Journal Article 2016 01 19 England BMJ Case Rep 101526291 1757 (...) -790X IM Abdominal Injuries diagnostic imaging etiology pathology surgery Adult Colectomy Football injuries Humans Laparotomy methods Male Pancreas injuries surgery Pancreatectomy Shock, Hemorrhagic diagnosis etiology Splenectomy Splenic Artery injuries surgery Wounds, Nonpenetrating diagnosis etiology pathology surgery 2016 1 21 6 0 2016 1 21 6 0 2016 12 15 6 0 epublish 26786533 bcr-2015-214124 10.1136/bcr-2015-214124 PMC4735394 Acta Radiol. 2015 Apr;56(4):387-96 24760286 N Engl J Med. 1994 Oct

2016 BMJ case reports

69. Laparascopic Splenectomy Due to Splenic Injury after Colonoscopy Full Text available with Trip Pro

Laparascopic Splenectomy Due to Splenic Injury after Colonoscopy Colonoscopy, which is routinely performed in diagnosis and treatment of colorectal disorders, is a reliable procedure. Its most frequent complications are bleeding and perforation. Splenic rupture is a very rarely met complication of colonoscopy, and delay in its diagnosis leads to increased morbidity and mortality. We presented a 69 years old female patient, who was diagnosed by computerized abdominal tomography, performed (...) bleeding, in other words, if there is a sub-capsular hematoma of the spleen, medical management by monitoring the vital signs may be preferred. Then, splenectomy should be performed at an appropriate time.

2016 The Eurasian journal of medicine

70. Variation in ICU Utilization and Mortality After Blunt Splenic Injury Full Text available with Trip Pro

Variation in ICU Utilization and Mortality After Blunt Splenic Injury Although trauma patients are frequently cared for in the intensive care unit (ICU), admission triage criteria are unclear and may vary among providers and institutions. The benefits of close monitoring must be weighed against the economic and opportunity costs of an ICU admission.We conducted a retrospective cohort study of patients treated for blunt splenic injuries from 2011-2014 at 30 level I and II Pennsylvania trauma (...) centers.Of 2587 patients with blunt splenic injuries, 63.9% (1654) were admitted to the ICU. Median injury severity score was 17 overall, 13 for non-ICU patients and 17 for ICU patients (P < 0.001). In multivariable logistic regression, ICU admission was not significantly associated with mortality. Center-level risk-adjusted ICU admission rates ranged from 17.9%-87.3%. Risk-adjusted mortality rates ranged from 1.2%-9.6%. There was no correlation between observed-to-expected ratios for ICU utilization

2016 The Journal of surgical research

71. Noninvasive management for iatrogenic splenic injury caused by chest tube insertion: a case report Full Text available with Trip Pro

Noninvasive management for iatrogenic splenic injury caused by chest tube insertion: a case report Splenic injury is one of the most critical complications of chest tube insertion and often requires invasive emergency management. However, noninvasive management such as delayed removal of the malpositioned tube may be considered for a stable patient without severe adverse event.

2016 Clinical Case Reports

72. Editor’s Highlight: Role of Spleen-Derived Macrophages in Ozone-Induced Lung Inflammation and Injury Full Text available with Trip Pro

Editor’s Highlight: Role of Spleen-Derived Macrophages in Ozone-Induced Lung Inflammation and Injury Macrophages and inflammatory mediators have been implicated in ozone toxicity. In these studies, we used splenectomized (SPX) mice to assess the contribution of splenic monocytes to pulmonary inflammation and injury induced by ozone. Cells and tissue were collected 24-72 h after exposure of mice to air or ozone (0.8 ppm, 3 h). Following ozone exposure, increased numbers of pro-inflammatory (...) ozone toxicity, as measured by decreases in bronchoalveolar lavage protein content and reduced 4-hydroxynonenal expression in the lung. These data suggest that the spleen is a source of pro-inflammatory/cytotoxic macrophages that contribute to ozone-induced lung injury, inflammation, and oxidative stress.© The Author 2016. Published by Oxford University Press on behalf of the Society of Toxicology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

2016 Toxicological Sciences

73. Colonoscopic Splenic Injury: A Simplified Radiologic Approach Full Text available with Trip Pro

Colonoscopic Splenic Injury: A Simplified Radiologic Approach Colonoscopy is a commonly performed procedure for diagnosis and treatment of large bowel diseases. Recognized complications include bleeding and perforation. Splenic injury during colonoscopy is a rare complication. We report a case of a 73-year-old woman who presented with left-sided abdominal pain after colonoscopy with finding of splenic injury on CT scan. She was managed conservatively. We discuss the diagnostic and therapeutic (...) approach to colonoscopic splenic injury.

2016 Case reports in gastrointestinal medicine

74. Splenic injury following elective colonoscopy: a rare complication Full Text available with Trip Pro

Splenic injury following elective colonoscopy: a rare complication Splenic injury is an extremely rare, yet serious, complication related to colonoscopy. So far, less than 80 cases have been reported worldwide since 1970. With the increasing use of colonoscopy, endoscopists, surgeons and radiologists are more likely to encounter this unusual complication. Increased splenocolic adhesions, splenomegaly or underlying splenic disease might, inter alia, constitute a predisposing factor. However (...) , it might also occur in patients without significant adhesions or underlying splenic pathology. Patients with abdominal pain, hypotension and a fall in hematocrit without rectal bleeding after colonoscopy, should be suspected of having splenic injury. Most patients present with symptoms within 24 hours after colonoscopy, nevertheless, delayed presentations have been described as well. We report such a case of splenic injury secondary to colonoscopy. The patient was presented with hemorrhagic shock

2016 Journal of surgical case reports

75. Comparison of MDCT protocols in trauma patients with suspected splenic injury: superior results with protocol that includes arterial and portal venous phase imaging Full Text available with Trip Pro

Comparison of MDCT protocols in trauma patients with suspected splenic injury: superior results with protocol that includes arterial and portal venous phase imaging We aimed to determine which intravenous contrast-enhanced multidetector computed tomography (MDCT) protocol produced the most accurate results for the detection of splenic vascular injury in hemodynamically stable patients who had sustained blunt abdominal trauma.We retrospectively reviewed 88 patients from 2003 to 2011 who (...) , which includes the arterial phase, in patients with suspected splenic injury and question the utility of obtaining a delayed sequence.

2016 Diagnostic and Interventional Radiology

76. Salmonella typhi Splenic Abscess Following Blunt Abdominal Injury: A Case Report Full Text available with Trip Pro

Salmonella typhi Splenic Abscess Following Blunt Abdominal Injury: A Case Report Splenic abscess as a complication of enteric fever due to Salmonella typhi is a rare entity. Here, we are presenting a case of splenic abscess caused by Salmonella typhi with a blunt injury to the abdomen as the predisposing factor. The patient underwent total splenectomy due to failure of conservative management. Splenic abscess is a potential life threatening disease if left untreated. In spite of its rarity

2016 Journal of clinical and diagnostic research : JCDR

77. Iatrogenic splenic injury: review of the literature and medico-legal issues Full Text available with Trip Pro

Iatrogenic splenic injury: review of the literature and medico-legal issues Iatrogenic splenic injury is a recognized complication in abdominal surgery. The aim of this paper is to understand the medico-legal issues of iatrogenic splenic injuries. We performed a literature review on PubMed and Scopus using iatrogenic splenic or spleen injury and iatrogenic splenic rupture as keywords. Iatrogenic splenic injury cases were identified. Most cases were related to colonoscopy, but we also identified (...) cases related to upper gastrointestinal procedures, colonic surgery, ERCP, left nephrectomy and/or adrenalectomy, percutaneous nephrolithotomy, vascular operations involving the abdominal aorta, gynecological operation, left lung biopsy, chest drain, very rarely spinal surgery and even cardiopulmonary resuscitation. There are several surgical procedures that can lead to a splenic injury. However, from a medico-legal point of view, it is important to assess whether the cause can be attributed

2016 Open Medicine

78. Management of paediatric splenic injury in the New South Wales trauma system. (Abstract)

Management of paediatric splenic injury in the New South Wales trauma system. Since the 1980's, paediatric surgeons have increasingly managed blunt splenic injury (BSI) in children non-operatively. However, studies in North America have shown higher operation rates in non-paediatric centres and by adult surgeons. This association has not been examined elsewhere.To investigate the management of BSI in New South Wales (NSW) children, to determine the patient and hospital factors related (...) , factors associated with operation included age (OR 1.11, 95% CI 1.01-1.18, p<0.05), massive splenic disruption (OR 3.10, 95% CI 1.61-6.19, p<0.001), hollow viscus injury (OR 11.03, 95% CI 3.46-34.28, p<0.001) and transfusion (OR 7.70, 95% CI 4.54-13.16, p<0.001). Management outside a paediatric trauma centre remained significantly associated with operation, whether it be metropolitan adult trauma centre (OR 4.22 95% CI 1.70-10.52, p<0.01), rural trauma centre (OR 3.72 95% CI 1.83-7.83, p<0.001

2016 Injury

79. Beneficial effect of Punica granatum peel extract on murine malaria-induced spleen injury. Full Text available with Trip Pro

Beneficial effect of Punica granatum peel extract on murine malaria-induced spleen injury. Multiple drug-resistant malaria parasites have been widely detected, which has encouraged research studies focused on discovering alternative therapies. Medicinal plants such as pomegranate, Punica granatum, have been proven to exhibit antiprotozoal effects and therefore, we examined its effects on murine malaria-induced splenic injury and oxidative stress in this study.Mice were divided into three groups (...) , a vehicle control and two groups that were infected with 10(6) Plasmodium chabaudi-parasitized red blood cells (RBCs). The third group was gavaged with 100 μL of 300 mg/kg pomegranate peel extract for 6 days. All mice were euthanized on day 6 post-infection.The results revealed the potential antimalarial, antioxidant, and anti-inflammatory effects of pomegranate. Furthermore, pomegranate peel extracts significantly reduced parasitemia and spleen index of the treated mice compared to the untreated group

2016 BMC Complementary and Alternative Medicine

80. Non-Operative Management Is As Effective As Immediate Splenectomy For Adult Patients with High-Grade Blunt Splenic Injury. (Abstract)

Non-Operative Management Is As Effective As Immediate Splenectomy For Adult Patients with High-Grade Blunt Splenic Injury. The comparative effectiveness of nonoperative management (NOM) vs immediate splenectomy (IS) for hemodynamically stable adult patients with grade IV or V blunt splenic injury (BSI) has not been clearly established in the literature.We performed a retrospective analysis of adult patients, from the 2013 to 2014 American College of Surgeons Trauma Quality Improvement Program (...) was not different between the IS and NOM patients (11.5% vs 10.0%, p = 0.33), although IS patients had a higher incidence of infectious complications (21.4% vs 16.9%, p = 0.02). The rate of NOM failure in our sample was 20.1%. Independent predictors of failed NOM included the presence of a bleeding disorder, early blood transfusion requirement, and grade V injury. Splenic artery embolization was associated with a decreased risk of NOM failure. Patients who had failed NOM had a lower in-hospital mortality rate

2016 Journal of the American College of Surgeons

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