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Splenic Injury

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81. Splenic Artery Ligation for Iatrogenic Injury in Esophagectomy Operations. Full Text available with Trip Pro

Splenic Artery Ligation for Iatrogenic Injury in Esophagectomy Operations. Studies have shown that splenic artery ligation without splenectomy can successfully control hemorrhage and preserve the spleen in splenic trauma. The short gastric arteries and left gastroepiploic arteries may be the most important part of the collateral blood supply to the spleen. Moreover, that the human spleen can also survive even if most of the short gastric arteries have been ligated along with the splenic artery (...) has also been proven. Revascularization of the spleen by collateral vessels from the superior mesenteric, pancreatic, and left inferior phrenic arteries has been demonstrated by celiac angiography. Thus, splenic artery ligation could be also an alternative to splenectomy for iatrogenic spleen injury in esophagectomy operations.Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

2016 Annals of Thoracic Surgery

82. Does angiography increase the risk of impairment in renal function during non-operative management of patients with blunt splenic injuries? A cross-sectional study in southern Taiwan. Full Text available with Trip Pro

Does angiography increase the risk of impairment in renal function during non-operative management of patients with blunt splenic injuries? A cross-sectional study in southern Taiwan. The aim of the present study was to assess whether angiography after contrast-enhanced CT (CECT) as per the policy of non-operative management would add to the risk of acute kidney injury in patients with blunt splenic injuries (BSIs).Cross-sectional study.Taiwan.Patients with BSI aged >16 years, admitted

2016 BMJ open

83. Peer review report 1 on “A systematic review of splenic injuries during colonoscopies: Evolving trends in presentation and management” Full Text available with Trip Pro

Peer review report 1 on “A systematic review of splenic injuries during colonoscopies: Evolving trends in presentation and management” Redirecting

2016 International Journal of Surgery

84. Blunt Splenic Injury: Use of a Multidetector CT-based Splenic Injury Grading System and Clinical Parameters for Triage of Patients at Admission. Full Text available with Trip Pro

Blunt Splenic Injury: Use of a Multidetector CT-based Splenic Injury Grading System and Clinical Parameters for Triage of Patients at Admission. To assess the use of a dual-phase multidetector computed tomography (CT)-based grading system alone and in combination with assessment of clinical parameters at triage of patients with blunt splenic injury for determination of appropriate treatment (observation, splenic artery embolization [SAE], or splenic surgery).This HIPAA-compliant retrospective (...) study was approved by the institutional review board, and the requirement for informed consent was waived. Between January 2009 and July 2011, 171 hemodynamically stable patients with blunt splenic injury underwent multidetector CT at admission to the hospital. Images were reviewed by applying a multidetector CT-based grading system, and the amount of hemoperitoneum was quantified. Demographic data, vital signs, laboratory values, injury severity score, abbreviated injury severity, final treatment

2014 Radiology

85. Spontaneous Splenic Rupture Two Weeks After Sleeve Gastrectomy. (Abstract)

Spontaneous Splenic Rupture Two Weeks After Sleeve Gastrectomy. Sleeve gastrectomy is one of the commonest bariatric procedures performed globally with an acceptable rate of reported complications. Splenic injury during this procedure is a rare but can be a serious complication. A 32-year-old male patient who had a spontaneous splenic rupture two weeks after an uneventful sleeve gastrectomy needed an emergency splenectomy. Spontaneous rupture after sleeve gastrectomy is an extremely rare

2020 Obesity Surgery

86. Predicting the Outcome of Non-operative Management of Splenic Trauma in South Africa. (Abstract)

managed with OP or NOM for splenic trauma were identified and analyzed descriptively. Multiple logistic regression analysis identified patients and clinical factors associated with management type.There were 127 patients with splenic injury. Median age was 29 [19-35] years with 42 (33%) women and 85 (67%) men. Blunt injuries occurred in the majority (81, 64%). Organ Injury Scale (OIS) grades included I (25, 20%), II (43, 34%), III (36, 28%), IV (15, 11%), and V (8, 6%). Nine patients expired (...) ratio, 1.4; 95%CI 1.1-1.9) were significantly associated with OP compared to NOM (p = 0.002; area under the curve 0.81).We have identified injury mechanism and admission lactate as factors predictive of OP in South African patients with splenic trauma. Timely presentation to definitive care affects both ICU duration of stay and mortality outcomes. Future global surgical efforts may focus on expanding non-operative management protocols and improving pre-hospital care in patients with splenic trauma.

2020 World Journal of Surgery

87. A rare case of malignant hypertension with splenic rupture and thrombotic microangiopathy: A case report. Full Text available with Trip Pro

A rare case of malignant hypertension with splenic rupture and thrombotic microangiopathy: A case report. Thrombotic microangiopathy (TMA) is characterized by endothelial injury followed by formation of multiple microthrombi in the target organs due to various causes, including malignant hypertension (MHT). Here, we reported a rare case of MHT with splenic TMA changes.A 27-year-old Chinese Han male with a history of hypertension and proteinuria, admitted to our hospital because of renal failure (...) with MHT and thrombocytopenia.This case diagnosed with TMA based on the patient's MHT and thrombocytopenia. The patient final diagnosis was confirmed by the spleen pathological findings, other differential diagnoses were ruled out.The patient was treated with hemodialysis and intravenous antihypertensive agents, and his condition gradually improved. However, he suddenly complained of abdominal pain and went into hemorrhagic shock, which was due to spontaneous spleen rupture on the third day

2020 Medicine

88. The cost to perform splenic artery embolisation following blunt trauma: Analysis from a level 1 Australian trauma centre. (Abstract)

The cost to perform splenic artery embolisation following blunt trauma: Analysis from a level 1 Australian trauma centre. Splenic artery embolisation (SAE) has been shown to be an effective treatment for haemodynamically stable patients with high-grade blunt splenic injury. However, there are no local estimates of how much treatment costs. The purpose of this study was to evaluate the cost of providing SAE to patients in the setting of blunt abdominal trauma at an Australian level 1 trauma (...) centre.This was a single-centre retrospective review of 10 patients who underwent splenic embolisation from December 2017 to December 2018 for the treatment of isolated blunt splenic injury, including cost of procedure and the entire admission. Costs included angiography costs including equipment, machine, staff, and post-procedural costs including pharmacy, general ward costs, orderlies, ward nursing, allied health, and further imaging.During the study period, patients remained an inpatient for a mean

2020 Injury

89. Comparison of the efficacy of five standard topical hemostats: a study in porcine liver and spleen models of surgical bleeding. Full Text available with Trip Pro

and spleen surgical bleeding models.Cutanplast Standard and Fast gelatin sponge and Emosist ORC gauze were tested in liver abrasion/incision, liver puncture and spleen incision/puncture injuries, and Cutanplast Standard and Fast gelatin powder products were tested in liver abrasion/incision injuries. There were 13 liver injury (five abrasion, five incision and three puncture) and six spleen injury (three puncture and three incision sites) sites per animal.Rapid hemostasis (≤ 2-5 min) was achieved (...) Comparison of the efficacy of five standard topical hemostats: a study in porcine liver and spleen models of surgical bleeding. Several topical hemostats are available to help control surgical bleeding. Cutanplast is a highly absorbent and porous gelatin product that is available in Fast sponge and powder forms. This study investigated the hemostatic efficacy of Cutanplast Standard and Fast gelatin sponge and powder and Emosist oxidized regenerated cellulose (ORC) gauze in porcine liver

2020 BMC Surgery

90. The Impact of Coronavirus Disease 2019 (COVID-19) on Liver Injury in China: A Systematic Review and Meta-analysis Full Text available with Trip Pro

Province, China 2 Diagnosis and Treatment Center for Liver, Gallbladder, Pancreas and Spleen System Diseases , Leshan City, Sichuan Province, China Abstract Background The evidence for the incidence and severity of liver injury in Chinese patients with COVID-19 is still controversial. Aims The purpose of this study was to summarize the incidence of liver injury and the differences between liver injury markers among different patients with COVID-19 in China. Methods Computer searches of PubMed, Embase (...) The Impact of Coronavirus Disease 2019 (COVID-19) on Liver Injury in China: A Systematic Review and Meta-analysis The Impact of Coronavirus Disease 2019 (COVID-19) on Liver Injury in China: A Systematic Review and Meta-analysis | medRxiv Search for this keyword The Impact of Coronavirus Disease 2019 (COVID-19) on Liver Injury in China: A Systematic Review and Meta-analysis Xin Zhao , Zehua Lei , Fengwei Gao , Qingyun Xie , Kangyi Jang , Jianping Wu , Jinqiang Fu , Bo Du , Zhixu Wang doi: https

2020 Cold Spring Harbor Laboratory

91. A Case of Splenic Laceration Presenting as a Delayed Complication of Colonoscopy. (Abstract)

pain and lightheadedness the day after a routine colonoscopy. Ultrasound demonstrated hemoperitoneum, and contrast-enhanced computed tomography of the abdomen revealed a large hemoperitoneum with active contrast extravasation from the laceration of the superior pole of the spleen. After resuscitation, the patient was managed with an emergency splenectomy. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Colonoscopy complications are frequently identified and managed in the ED. Splenic (...) laceration should be on the differential for patients that present with abdominal pain or hypotension after colonoscopy. Splenic injury carries a high mortality risk, and prompt, accurate diagnosis can be lifesaving.Copyright © 2019 Elsevier Inc. All rights reserved.

2019 Journal of Emergency Medicine

92. Multiple Splenic Infarcts Complicating Plasmodium vivax Malaria. (Abstract)

Multiple Splenic Infarcts Complicating Plasmodium vivax Malaria. Splenic infarct is a rare complication in Plasmodium vivax malaria. We report a case of splenic infarction with acute kidney injury in a case of P. vivax malaria in a 13-year-old male child who presented to the emergency department with severe pain in the left hypochondrium. The patient was managed with intravenous artesunate and oral primaquine. Pain in left hypochondrium in children with P. vivax malaria due to splenic

2019 Pediatric Emergency Care

93. Traumatic spleen rupture diagnosed during postmortem dissection: A STROBE-compliant retrospective study. Full Text available with Trip Pro

Traumatic spleen rupture diagnosed during postmortem dissection: A STROBE-compliant retrospective study. Spleen is typically injured in blunt abdominal trauma. Spleen injuries make 42% of all blunt abdominal injuries. The aim of this study was to perform a retrospective assessment of the cases of acute and subacute isolated traumatic spleen ruptures.A retrospective study performed on 50 patients, whose cause of death was isolated spleen rupture and bleeding into the abdominal cavity.An acute (...) spleen rupture was diagnosed in 47 cases, whereas the rest 3 cases demonstrated a subacute rupture. In cases of acute spleen rupture, the mean weight of spleen was 309.6 g, whereas in 3 cases of subacute rupture the mean weight of the organ achieved 710 g. The mean weight of spleen in the control group with no spleen rupture was 144.7 g.Recording of the cases of isolated acute and subacute traumatic spleen ruptures and morphological assessment of them are important in forensic pathology science

2019 Medicine

94. Selenium Deficiency Aggravates Aflatoxin B1-Induced Immunotoxicity in Chick Spleen by Regulating 6 Selenoprotein Genes and Redox/Inflammation/Apoptotic Signaling. (Abstract)

Selenium Deficiency Aggravates Aflatoxin B1-Induced Immunotoxicity in Chick Spleen by Regulating 6 Selenoprotein Genes and Redox/Inflammation/Apoptotic Signaling. Selenium (Se) plays a protective role in aflatoxin B1 (AFB1)-induced splenic immunotoxicity in chicks.This study was designed to reveal the underlying mechanism of Se-mediated protection against AFB1-induced splenic injury in broilers.Four groups of 1-d-old Cobb male broilers (n = 5 cages/diet, 6 chicks/cage) were arranged in a 3-wk 2 (...)  × 2 factorial design trial whereby they were fed an Se-deficient, corn- and soy-based diet [base diet (BD), 36 μg Se/kg], BD plus 1.0 mg AFB1/kg, BD plus 0.3 mg Se/kg, or BD plus 1.0 mg AFB1/kg and 0.3 mg Se/kg (as 2-hydroxy-4-methylselenobutanoic acid). Serum and spleen were collected at week 3 to assay for cytokines, histology, redox status, selected inflammation- and apoptosis-related genes and proteins, and the selenogenome.Dietary AFB1 induced growth retardation and spleen injury, decreasing

2019 Journal of Nutrition

95. Blunt splenic injury and severe brain injury: a decision analysis and implications for care Full Text available with Trip Pro

Blunt splenic injury and severe brain injury: a decision analysis and implications for care The initial nonoperative management (NOM) of blunt splenic injuries in hemodynamically stable patients is common. In soldiers who experience blunt splenic injuries with concomitant severe brain injury while on deployment, however, NOM may put the injured soldier at risk for secondary brain injury from prolonged hypotension.We conducted a decision analysis using a Markov process to evaluate 2 strategies (...) for managing hemodynamically stable patients with blunt splenic injuries and severe brain injury--immediate splenectomy and NOM--in the setting of a field hospital with surgical capability but no angiography capabilities. We considered the base case of a 40-year-old man with a life expectancy of 78 years who experienced blunt trauma resulting in a severe traumatic brain injury and an isolated splenic injury with an estimated failure rate of NOM of 19.6%. The primary outcome measured was life expectancy. We

2015 Canadian Journal of Surgery

96. Splenic angioembolisation versus non-operative management for splenic injury: a systematic review

Splenic angioembolisation versus non-operative management for splenic injury: a systematic review 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") for correspondence: Organisation web address

2016 PROSPERO

97. Surgical versus non-surgical management of abdominal injury. (Abstract)

Surgical versus non-surgical management of abdominal injury. Injury to the abdomen can be blunt or penetrating. Abdominal injury can damage internal organs such as the liver, spleen, kidneys, intestine, and large blood vessels. There are controversies about the best approach to manage abdominal injuries.To assess the effects of surgical and non-surgical interventions in the management of abdominal trauma in a haemodynamically stable and non-peritonitic abdomen.We searched the Cochrane Injuries (...) injury who were haemodynamically stable with no signs of peritonitis. The abdominal injury could be blunt or penetrating.Two review authors independently applied the selection criteria. Data were extracted by two authors using a standard data extraction form, and are reported narratively.Two studies are included, which involved a total of 114 people with penetrating abdominal injuries. Both studies are at moderate risk of bias because the randomisation methods are not fully described

2015 Cochrane

98. Non-operative management versus operative management in high-grade blunt hepatic injury. (Abstract)

Non-operative management versus operative management in high-grade blunt hepatic injury. Surgery used to be the treatment of choice in cases of blunt hepatic injury, but this approach gradually changed over the last two decades as increasing non-operative management (NOM) of splenic injury led to its use for hepatic injury. The improvement in critical care monitoring and computed tomographic scanning, as well as the more frequent use of interventional radiology techniques, has helped to bring (...) about this change to non-operative management. Liver trauma ranges from a small capsular tear, without parenchymal laceration, to massive parenchymal injury with major hepatic vein/retrohepatic vena cava lesions. In 1994, the Organ Injury Scaling Committee of the American Association for the Surgery of Trauma (AAST) revised the Hepatic Injury Scale to have a range from grade I to VI. Minor injuries (grade I or II) are the most frequent liver injuries (80% to 90% of all cases); severe injuries

2015 Cochrane

99. Concomitant hollow viscus injuries in patients with blunt hepatic and splenic injuries: An analysis of a National Trauma Registry database. (Abstract)

Concomitant hollow viscus injuries in patients with blunt hepatic and splenic injuries: An analysis of a National Trauma Registry database. Non-operative management has become the standard approach for treating stable patients sustaining blunt hepatic or splenic injuries in the absence of other indications for laparotomy. The liberal use of computed tomography (CT) has reduced the rate of unnecessary immediate laparotomies; however, due to its limited sensitivity in the diagnosis of hollow (...) viscus injuries (HVI), this may be at the expense of a rise in the incidence of missed HVI. The aim of this study was to assess the incidence of concomitant HVI in blunt trauma patients diagnosed with hepatic and/or splenic injuries, and to evaluate whether a correlation exists between this incidence and the severity of hepatic or splenic injuries.A retrospective cohort study involving blunt trauma patients with splenic and/or liver injuries, between the years 1998 and 2012 registered in the Israel

2014 Injury

100. Blunt splenic injury: are early adverse events related to trauma, nonoperative management, or surgery? Full Text available with Trip Pro

Blunt splenic injury: are early adverse events related to trauma, nonoperative management, or surgery? We aimed to compare clinical outcomes and early adverse events of operative management (OM), nonoperative management (NOM), and NOM with splenic artery embolization (SAE) in blunt splenic injury (BSI) and identify the prognostic factors.Medical records of 136 consecutive patients with BSI admitted to a trauma center from 2005 to 2010 were retrospectively reviewed. Patients were separated (...) into three groups: OM, NOM, and SAE. We focused on associated injuries and early adverse events. Multivariate analysis was performed on 23 prognostic factors to find predictors.The total survival rate was 97.1%, with four deaths all occurred in the OM group. The spleen salvage rate was 91% in NOM and SAE. At least one adverse event was observed in 32.8%, 62%, and 96% of patients in NOM, SAE, and OM groups, respectively (P < 0.001). We found significantly more deaths, infectious complications, pleural

2015 Diagnostic and Interventional Radiology

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