Anesthesia Assistance in Outpatient Colonoscopy and Risk of Aspiration Pneumonia, Bowel Perforation, and Splenic Injury The increase in use of anesthesia assistance (AA) to achieve deep sedation with propofol during colonoscopy has significantly increased colonoscopy costs without evidence for increased quality and with possible harm. We investigated the effects of AA on colonoscopy complications, specifically bowel perforation, aspiration pneumonia, and splenic injury.In a population-based (...) cohort study using administrative databases, we studied adults in Ontario, Canada undergoing outpatient colonoscopy from 2005 through 2012. Patient, endoscopist, institution, and procedure factors were derived. The primary outcome was bowel perforation, defined using a validated algorithm. Secondary outcomes were splenic injury and aspiration pneumonia. Using a matched propensity score approach, we matched persons who had colonoscopy with AA (1:1) with those who did not. We used logistic regression

Splenic injury and rupture

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.

Splenic Injury, Blunt, Selective Nonoperative Management of Splenic Injury, Blunt, Selective Nonoperative Management of - Practice Management Guideline Search » Splenic Injury, Blunt, Selective Nonoperative Management of Published 2012 Citation: Authors Stassen, Nicole A. MD; Bhullar, Indermeet MD; Cheng, Julius D. MD; Crandall, Marie L. MD; Friese, Randall S. MD; Guillamondegui, Oscar D. MD; Jawa, Randeep S. MD; Maung, Adrian A. MD; Rohs, Thomas J. Jr MD; Sangosanya, Ayodele MD; Schuster (...) 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

Hospital characteristics associated with the management of pediatric splenic injuries. Despite evidence that more than 90% of children with traumatic injuries to the spleen can be successfully managed nonoperatively, there is significant variation in the use of splenectomy. As asplenic children are at increased risk of overwhelming postsplenectomy infection, nonoperative management may be considered a quality of care indicator.To test the hypothesis that children are more likely to undergo (...) %) with splenic injuries receiving care at children's hospitals underwent splenectomy compared with 383 children (15.4%) cared for at general hospitals (P<.001). After adjusting for patient characteristics, injury severity, and hospital characteristics, splenectomy was more likely among children treated at general hospitals (odds ratio, 5.01; 95% confidence interval, 2.21-11.36) than among children treated at children's hospitals.There is considerable variation in the management of pediatric splenic injuries

Management outcomes in splenic injury: a statewide trauma center review Management outcomes in splenic injury: a statewide trauma center review Management outcomes in splenic injury: a statewide trauma center review Clancy T V, Ramshaw D G, Maxwell J G, Covington D L, Churchill M P, Rutledge R, Oller D W, Cunningham P R, Meredith J W, Thomason M H, Baker C C Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract (...) contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Nonoperative versus operative methods of management as initial therapeutic options for the management of patients with splenic injury. Type of intervention Diagnosis; treatment. Economic study type Cost-effectiveness analysis. Study population Patients aged 17 years or older, with splenic trauma. Setting Hospital

Management of pediatric blunt splenic injury: comparison of pediatric and adult trauma surgeons Management of pediatric blunt splenic injury: comparison of pediatric and adult trauma surgeons Management of pediatric blunt splenic injury: comparison of pediatric and adult trauma surgeons Keller M S, Vane D W Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results (...) and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Management of pediatric blunt splenic injury by different surgeons (paediatric and adult trauma). Type of intervention Treatment (disease management). Economic study type Cost-effectiveness study. Study population Children aged under 19 years with blunt splenic injury. Setting Hospital. The study was conducted by the Department of Pediatric Surgery, University of Vermont, USA