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Splenic Injury

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101. Prospective trial of angiography and embolization for all grade III to V blunt splenic injuries: nonoperative management success rate is significantly improved. (PubMed)

Prospective trial of angiography and embolization for all grade III to V blunt splenic injuries: nonoperative management success rate is significantly improved. Nonoperative management (NOM) of blunt splenic injury is well accepted. Substantial failure rates in higher injury grades remain common, with one large study reporting rates of 19.6%, 33.3%, and 75% for grades III, IV, and V, respectively. Retrospective data show angiography and embolization can increase salvage rates in these severe (...) injuries. We developed a protocol requiring referral of all blunt splenic injuries, grades III to V, without indication for immediate operation for angiography and embolization. We hypothesized that angiography and embolization of high-grade blunt splenic injury would reduce NOM failure rates in this population.This was a prospective study at our Level I trauma center as part of a performance-improvement project. Demographics, injury characteristics, and outcomes were compared with historic controls

2014 Journal of the American College of Surgeons

102. Emergency treatment of splenic injury in a novel mobile minimally invasive interventional shelter following disaster: a feasibility study. (Full text)

Emergency treatment of splenic injury in a novel mobile minimally invasive interventional shelter following disaster: a feasibility study. There has been an increase in natural disasters in recent years, which leads to a great number of injuries and deaths. It still remains an unsolved problem to treat patients with vascular injury of solid organs effectively following natural disasters, but on-spot emergency interventional transcatheter arterial embolization (TAE) has been highly recommended (...) to cure serious vascular injury of solid organs nowadays. Spleen is the most vulnerable abdominal organ, severe arterial hemorrhage of which can cause death if untreated timely. In this research, we aimed to study the possibility of performing emergency surgical intervention in mobile minimally invasive interventional shelter for splenic injury in the case of natural disasters.First, the mobile minimally invasive interventional shelter was unfolded in the field, and then disinfection and preoperative

2014 Scandinavian journal of trauma, resuscitation and emergency medicine PubMed

103. The contemporary management of penetrating splenic injury. (PubMed)

The contemporary management of penetrating splenic injury. Selective non-operative management (NOM) is standard of care for clinically stable patients with blunt splenic trauma and expectant management approaches are increasingly utilised in penetrating abdominal trauma, including in the setting of solid organ injury. Despite this evolution of clinical practice, little is known about the safety and efficacy of NOM in penetrating splenic injury.Trauma registry and medical record review (...) identified all consecutive patients presenting to LAC+USC Medical Center with penetrating splenic injury between January 2001 and December 2011. Associated injuries, incidence and nature of operative intervention, local and systemic complications and mortality were determined.During the study period, 225 patients experienced penetrating splenic trauma. The majority (187/225, 83%) underwent emergent laparotomy. Thirty-eight clinically stable patients underwent a deliberate trial of NOM and 24/38 (63

2014 Injury

104. Pleural effusion following blunt splenic injury in the pediatric trauma population. (PubMed)

Pleural effusion following blunt splenic injury in the pediatric trauma population. Pleural effusion is a potential complication following blunt splenic injury. The incidence, risk factors, and clinical management are not well described in children.Ten-year retrospective review (January 2000-December 2010) of an institutional pediatric trauma registry identified 318 children with blunt splenic injury.Of 274 evaluable nonoperatively managed pediatric blunt splenic injures, 12 patients (4.4 (...) ), respectively. In multivariate analysis, high-grade splenic injury (IV-V) (OR 16.5, p=0.001) was associated with higher odds of developing a pleural effusion compared to low-grade splenic injury (I-III).Pleural effusion following pediatric blunt splenic injury has an incidence of 4.4% and is associated with high-grade splenic injuries and longer lengths of stay. While some symptomatic patients may be successfully managed medically, many require tube thoracostomy for progressive respiratory

2014 Journal of Pediatric Surgery

105. Splenic injury after blunt abdominal trauma during a soccer (football) game. (PubMed)

Splenic injury after blunt abdominal trauma during a soccer (football) game. The spleen is the most commonly injured abdominal organ in children who sustain blunt abdominal trauma, and pediatric splenic injury may result from minor mechanisms of injury, including sports participation. We present 2 cases of splenic injury in soccer goalies because of blunt abdominal trauma sustained during game play. Although abdominal organ injuries are uncommon in soccer, emergency medicine and primary care

2014 Pediatric Emergency Care

106. Are Procedures Codes in Claims Data a Reliable Indicator of Intraoperative Splenic Injury Compared with Clinical Registry Data? (PubMed)

Are Procedures Codes in Claims Data a Reliable Indicator of Intraoperative Splenic Injury Compared with Clinical Registry Data? Identifying iatrogenic injuries using existing data sources is important for improved transparency in the occurrence of intraoperative events. There is evidence that procedure codes are reliably recorded in claims data. The objective of this study was to assess whether concurrent splenic procedure codes in patients undergoing colectomy procedures are reliably coded (...) 114 patients (1%) who had a concurrent splenic procedure code recorded in either ACS NSQIP or Medicare inpatient claims. There were 7 patients who had a splenic injury diagnosis code recorded in either data source. Agreement of splenic procedure codes between the data sources was substantial (κ statistic 0.72; 95% CI, 0.64-0.79). Medicare inpatient claims identified 81% of the splenic procedure codes recorded in ACS NSQIP, and 99% of the patients without a splenic procedure code.It is feasible

2014 Journal of the American College of Surgeons

107. Splenic Injury During Resection for Esophageal Cancer: Risk Factors and Consequences. (PubMed)

Splenic Injury During Resection for Esophageal Cancer: Risk Factors and Consequences. Esophageal cancer surgery carries a risk of splenic injury, which may require splenectomy, but predictors of such events remain uncertain. Moreover, the hypothesis that incidental splenectomy carries a worse prognosis deserves attention.A population-based, nationwide cohort study was conducted on 1679 patients who underwent resection for esophageal cancer in Sweden in 1987 to 2010, with follow-up until (...) February 2012. Predictors of splenic injury and incidental splenectomy were analyzed using multivariable logistic regression, providing odds ratios (ORs) with 95% confidence intervals (CIs). Associations between incidental splenectomy and risk of mortality and severe infections were analyzed using multivariable Cox regression, providing hazard ratios (HRs) with 95% CIs.Higher surgeon volume of esophageal cancer resection decreased the risk of splenic injury and incidental splenectomy (OR: 0.58; 95% CI

2014 Annals of Surgery

108. Simvastatin Reduces Burn Injury-Induced Splenic Apoptosis via Downregulation of the TNF-α/NF-кB Pathway. (Full text)

Simvastatin Reduces Burn Injury-Induced Splenic Apoptosis via Downregulation of the TNF-α/NF-кB Pathway. Recent studies have suggested that epidermal burn injuries are associated with inflammation and immune dysfunction. Simvastatin has been shown to possess potent anti-inflammatory properties. Thus, we hypothesized that simvastatin protects against burn-induced apoptosis in the spleen via its anti-inflammatory activity.Wild-type, tumor necrosis factor alpha knockout (TNF-α KO) and NF-κB KO (...) mice were subjected to full-thickness burn injury or sham treatment. The mice then were treated with or without simvastatin, and the spleen was harvested to measure the extent of apoptosis. Expression levels of TNF-α and NF-κB were also determined in spleen tissue and serum.Burn injury induced significant splenic apoptosis and systemic cytokine production. Simvastatin protected the spleen from apoptosis, reduced cytokine production in the serum, and increased the survival rate. Simvastatin

2014 Annals of Surgery PubMed

109. Immunologic Response to Pneumococcal Polysaccharide Vaccine in Splenic Injury Patients

Immunologic Response to Pneumococcal Polysaccharide Vaccine in Splenic Injury Patients Immunologic Response to Pneumococcal Polysaccharide Vaccine in Splenic Injury Patients - 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. Immunologic Response to Pneumococcal Polysaccharide Vaccine in Splenic Injury Patients The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT02232191 Recruitment Status : Recruiting First Posted : September 5

2014 Clinical Trials

110. Ultrasonography of the healing process during a 3-month follow-up after a splenic injury (Full text)

Ultrasonography of the healing process during a 3-month follow-up after a splenic injury We present a 14-year-old boy with a grade III splenic injury due to a bicycle accident, who was treated conservatively. The boy's medical history included splenomegaly due to thalassemia. The splenic lesion was initially investigated with computed tomography (CT) and then, was followed by ultrasonography for 3 months. CT revealed a large intraparenchymal hematoma which appeared hyperechoic

2014 Ultrasonography PubMed

111. Reliability of injury grading systems for patients with blunt splenic trauma. (PubMed)

Reliability of injury grading systems for patients with blunt splenic trauma. The most widely used grading system for blunt splenic injury is the American Association for the Surgery of Trauma (AAST) organ injury scale. In 2007 a new grading system was developed. This 'Baltimore CT grading system' is superior to the AAST classification system in predicting the need for angiography and embolization or surgery. The objective of this study was to assess inter- and intraobserver reliability between (...) radiologists in classifying splenic injury according to both grading systems.CT scans of 83 patients with blunt splenic injury admitted between 1998 and 2008 to an academic Level 1 trauma centre were retrospectively reviewed. Inter and intrarater reliability were expressed in Cohen's or weighted Kappa values.Overall weighted interobserver Kappa coefficients for the AAST and 'Baltimore CT grading system' were respectively substantial (kappa=0.80) and almost perfect (kappa=0.85). Average weighted

2014 Injury

112. Preserved function after angioembolisation of splenic injury in children and adolescents: a case control study. (PubMed)

Preserved function after angioembolisation of splenic injury in children and adolescents: a case control study. Non-operative management for blunt splenic injuries was introduced to reduce the risk of overwhelming post splenectomy infection in children. To increase splenic preservation rates, splenic artery embolization (SAE) was added to our institutional treatment protocol in 2002. In the presence of clinical signs of ongoing bleeding, SAE was considered also in children. To our knowledge (...) , the long term splenic function after SAE performed in the paediatric population has not been evaluated and constitutes the aim of the present study.A total of 11 SAE patients less than 17 years of age at the time of injury were included with 11 healthy volunteers serving as matched controls. Clinical examination, medical history, general blood counts, immunoglobulin quantifications and flowcytometric analysis of lymphocyte phenotypes were performed. Peripheral blood smears were examined for Howell

2014 Injury

113. Time to intervention in patients with splenic injury in a Dutch level 1 trauma centre. (PubMed)

Time to intervention in patients with splenic injury in a Dutch level 1 trauma centre. Timely intervention in patients with splenic injury is essential, since delay to treatment is associated with an increased risk of mortality. Transcatheter Arterial Embolisation (TAE) is increasingly used as an adjunct to non-operative management. The aim of this study was to report time intervals between admission to the trauma room and start of intervention (TAE or splenic surgery) in patients with splenic (...) injury.Consecutive patients with splenic injury aged ≥ 16 years admitted between January 2006 and January 2012 were included. Data were reported according to haemodynamic status (stable versus unstable). In haemodynamically (HD) unstable patients, transfusion requirement, intervention-related complications and the need for a re-intervention were compared between the TAE and splenic surgery group.The cohort consisted of 96 adults of whom 16 were HD unstable on admission. In HD stable patients, median time

2014 Injury

114. Population-based analysis of blunt splenic injury management in children: operative rate is an informative quality of care indicator. (PubMed)

Population-based analysis of blunt splenic injury management in children: operative rate is an informative quality of care indicator. In hemodynamically normal children with blunt splenic injury (BSI), the standard of care is non-operative management. Several studies have reported that non-paediatric and non-trauma centres have higher operative rates in children with BSI compared to paediatric hospitals and trauma centres. We investigate the feasibility of using operative rate for BSI (...) -level observed to expected (O/E) ratios for rate of operative management.We identified 3122 children with BSI. The majority (74%) were isolated splenic injuries and the grade of splenic injury was specified in 45% of cases (n=1391, 38% grade I or II; 62% grade III, IV, or V). The overall operative rate was 11% (n=315), of which 9% were total splenectomy and 2% were spleen-preserving operations. After adjusting for age, gender, mechanism of injury, splenic injury grade, ISS, and centre volume

2014 Injury

115. Increasing number of fractured ribs is not predictive of the severity of splenic injury following blunt trauma: an analysis of a National Trauma Registry database. (PubMed)

Increasing number of fractured ribs is not predictive of the severity of splenic injury following blunt trauma: an analysis of a National Trauma Registry database. Association between rib fractures and incidence of abdominal solid organs injury is well described. However, the correlation between the number of fractured ribs and severity of splenic injury is not clear. The purpose of this study was to assess whether an increasing number of rib fractures predicts the severity of splenic injury (...) in blunt trauma patients.A retrospective cohort study involving blunt trauma patients with concomitant splenic injuries and rib fractures, between the years 1998 and 2012, registered in the Israeli National Trauma Registry.Of 321,618 patients with blunt mechanism of trauma, 57,130 had torso injuries, and of these 14,651 patients sustained rib fractures, and 3691 patients suffered from splenic injury. Concomitant splenic injury occurred in 1326 of the patients with rib fractures (9.1%), as compared

2014 Injury

116. Presentation and management of splenic injury after colonoscopy: a systematic review. (PubMed)

Presentation and management of splenic injury after colonoscopy: a systematic review. This study reviewed all single experience of splenic injuries after colonoscopy in the last 40 years to define the possible risk factors and the management of this complication. A MEDLINE and a PubMed search was undertaken to identify articles in English, French, Spanish, and Italian from 1974 to 2012 using the key words: "splenic injury," "splenic rupture," and "colonoscopy." Data were analyzed using (...) descriptive statistic. A total of 103 cases have been described in 75 reports. The majority of the patients were women (71.56%) and 6.85% underwent previous pelvic surgery. The mean age was 63 years (range, 29 to 90 y). About 61 of the 103 studies (59.2%) reported the presence or the absence of previous abdominal surgery and within these, only 31 of 61 patients (50.82%) underwent previous abdominal surgery. In this review, over half of the patients with splenic injury underwent colonoscopy for routine

2014 Surgical laparoscopy, endoscopy & percutaneous techniques

117. Splenic Laceration and Pulmonary Contusion Injury From Bean Bag Weapon (Full text)

Splenic Laceration and Pulmonary Contusion Injury From Bean Bag Weapon 24672591 2015 10 30 2018 11 13 1936-900X 15 2 2014 Mar The western journal of emergency medicine West J Emerg Med Splenic laceration and pulmonary contusion injury from bean bag weapon. 118-9 10.5811/westjem.2013.10.19900 Patel Amar A Pennsylvania State University, College of Medicine, Hershey, Pennsylvania. Toohey Shannon S University of California Irvine Medical Center, Department of Emergency Medicine, Orange, California (...) . Boysen-Osborn Megan M University of California Irvine Medical Center, Department of Emergency Medicine, Orange, California. eng Case Reports Journal Article United States West J Emerg Med 101476450 1936-900X IM Contusions diagnosis diagnostic imaging etiology Humans Lacerations diagnosis diagnostic imaging etiology Lung Injury diagnosis diagnostic imaging etiology Male Middle Aged Spleen injuries Tomography, X-Ray Computed Wounds, Gunshot diagnosis diagnostic imaging Original DateCompleted: 20140327

2014 Western Journal of Emergency Medicine PubMed

118. 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

119. Choroidal Neovascularization Is Inhibited in Splenic-Denervated or Splenectomized Mice with a Concomitant Decrease in Intraocular Macrophage (Full text)

Choroidal Neovascularization Is Inhibited in Splenic-Denervated or Splenectomized Mice with a Concomitant Decrease in Intraocular Macrophage To determine the involvement of sympathetic activity in choroidal neovascularization (CNV) using laser-induced CNV in a mouse model.We investigated changes in the proportions of intraocular lymphocytes, granulocytes, and three macrophage subtypes (Ly6Chi, Ly6Cint, and Ly6Clo) after laser injury in mice using flow cytometry, and evaluated CNV lesion size (...) in mice lacking inflammatory cells. Further, we evaluated the lesion size in mice administered the β3 receptor antagonist, splenic-denervated and splenectomized mice. We also assessed changes in the proportions of intraocular macrophages and peripheral blood monocytes in splenic-denervated and splenectomized mice. Lastly, lesion size was compared between splenic-denervated mice with or without adoptive transfer of macrophages following laser injury. After Ly5.1 mice spleen-derived Ly6Chi cells were

2016 PloS one PubMed

120. Splenic CD11clowCD45RBhigh dendritic cells derived from endotoxin-tolerant mice attenuate experimental acute liver failure (Full text)

expression levels of CD40, CD80, and MHC-II markers and stronger inhibition of allogenic T cells and regulation of IL-10 and IL-12 secretion than splenic DCregs from normal mice (nDCregs). Moreover, the mRNA and protein levels of TNF-α and P65 in splenic ET-DCregs were significantly lower than those in the splenic nDCregs. The survival rate was significantly increased and liver injury was mitigated in mice with ALF treated with splenic ET-DCregs. In addition, A20 expression was decreased in the liver (...) Splenic CD11clowCD45RBhigh dendritic cells derived from endotoxin-tolerant mice attenuate experimental acute liver failure Endotoxin tolerance (ET) is suggested to attenuate the severity of acute liver failure (ALF) in mice, possibly through both innate and adaptive immunity. However, the involvement of regulatory dendritic cells (DCregs) in ET has not been fully elucidated. In this study, their effect on ALF in mice was investigated. Splenic DCregs from ET-exposed mice (ET-DCregs) showed lower

2016 Scientific reports PubMed

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