Selective angiographic embolization of blunt splenic traumatic injuries in adults decreases failure rates of nonoperative management

2012 ◽  
Vol 72 (5) ◽  
pp. 1456
Author(s):  
Indermeet S. Bhullar ◽  
Eric R. Frykberg ◽  
Daniel Siragusa ◽  
David Chesire ◽  
Julia Paul ◽  
...  
Keyword(s):  
Nonoperative Management ◽  
Angiographic Embolization ◽  
Failure Rates ◽  
Traumatic Injuries

Selective angiographic embolization of blunt splenic traumatic injuries in adults decreases failure rate of nonoperative management

2012 ◽  
Vol 72 (5) ◽  
pp. 1127-1134 ◽  
Author(s):  
Indermeet S. Bhullar ◽  
Eric R. Frykberg ◽  
Daniel Siragusa ◽  
David Chesire ◽  
Julia Paul ◽  
...  
Keyword(s):  
Failure Rate ◽  
Nonoperative Management ◽  
Angiographic Embolization ◽  
Traumatic Injuries

scholarly journals Racial Disparities at Mixed-Race and Minority Hospitals

2020 ◽  
pp. 000313482094736
Author(s):  
Christopher J. Tignanelli ◽  
Bradly Watarai ◽  
Yunhua Fan ◽  
Ashley Petersen ◽  
Mark Hemmila ◽  
...  
Keyword(s):  
Racial Disparities ◽  
Mixed Race ◽  
Data Bank ◽  
Primary Objective ◽  
Angiographic Embolization ◽  
High Grade ◽  
Traumatic Injuries ◽  
White Males ◽  
National Trauma Data Bank ◽  
High Acuity

Introduction Racial and socioeconomic disparities in health access and outcomes for many conditions is well known. However, for time-sensitive high-acuity diseases such as traumatic injuries, disparities in access and outcomes should be significantly diminished. Our primary objective was to characterize racial disparities across majority, mixed-race, and minority hospitals for African American ([AA] vs White) males with high-grade splenic injuries. Methods Data from the National Trauma Data Bank were utilized from 2007 to 2015; 24 855 AA or White males with high-grade splenic injuries were included. Multilevel mixed-effects regression analysis was used to evaluate disparities in outcomes and resource allocation. Results Mortality was significantly higher for AA males at mixed-race (OR 1.6; 95% CI 1.3-2.1; P < .001) and minority (OR 2.1; 95% CI 1.5-3.0; P < .001) hospitals, but not at majority hospitals. At minority hospitals, AA males were significantly less likely to be admitted to the intensive care unit (OR 0.7; 95% CI, 0.49-0.97; P = .04) and experienced a significantly longer time to surgery (IRR 1.5; P = .02). Minority hospitals were significantly more likely to have failures from angiographic embolization requiring operative intervention (OR 2.2, P = .009). At both types of nonmajority hospitals, AA males with penetrating injuries were more likely to be managed with angiography (mixed-race hospitals: OR 1.7; P = .046 vs minority hospitals: OR 1.6; P = .08). Discussion While multiple studies have shown that minority hospitals have increased mortality compared to majority hospitals, this study found this disparity only existed for AAs.

scholarly journals Bleeding from Small Intestine: No Man's Land

2020 ◽  
Vol 33 (01) ◽  
pp. 016-021 ◽  
Author(s):  
Ara Sahakian ◽  
Sang W. Lee ◽  
Joongho Shin
Keyword(s):  
Small Intestine ◽  
Nonoperative Management ◽  
Hemodynamic Instability ◽  
Accurate Diagnosis ◽  
Angiographic Embolization ◽  
Mortality And Morbidity ◽  
Surgical Exploration ◽  
Intraoperative Enteroscopy ◽  
No Man's Land ◽  
Mass Lesions

AbstractBleedings from small intestine account for 5% of all gastrointestinal bleeding. With advanced endoscopic tools, such as video capsule endoscopy and deep enteroscopy, accurate diagnosis and treatment is possible in majority of cases with low mortality and morbidity. Nonoperative management includes endoscopic hemostasis and angiographic embolization. Recurrence after initial treatment is relatively common. Surgery is reserved for the cases that are refractory to endoscopic or angiographic treatment, bleeding from tumor or mass lesions, or hemodynamic instability. At the time of surgical exploration, unless the lesion has been marked by endoscopic tattoo or clip, intraoperative enteroscopy is often necessary to localize the lesion.

Nonoperative management of pediatric splenic injury with angiographic embolization

2005 ◽  
Vol 40 (11) ◽  
pp. e63-e64 ◽  
Author(s):  
Pål A. Naess ◽  
Christine Gaarder ◽  
Johann B. Dormagen
Keyword(s):  
Splenic Injury ◽  
Nonoperative Management ◽  
Angiographic Embolization

Has the Pendulum Swung Too Far? The Impact of Missed Abdominal Injuries in the Era of Nonoperative Management

2009 ◽  
Vol 75 (7) ◽  
pp. 558-564 ◽  
Author(s):  
Lindsay M. Fairfax ◽  
A. Britton Christmas ◽  
Matthew Deaugustinis ◽  
Latiffany Gordon ◽  
Karen Head ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Nonoperative Management ◽  
Group Versus ◽  
Hospital Length Of Stay ◽  
Abdominal Injuries ◽  
Traumatic Injuries ◽  
Trauma Service ◽  
Severity Scores ◽  
Severity Of Injury ◽  
The Impact

Nonoperative management for traumatic injuries has significantly influenced trauma care during the last decade. We undertook this study to assess the impact of nontherapeutic laparotomies for suspected abdominal injuries compared with delayed laparotomies for questionable abdominal injuries for patients with abdominal trauma. The records of patients admitted to the trauma service between 2002 and 2007 who underwent laparotomies deemed nontherapeutic or delayed were retrospectively reviewed. Demographics, severity of injury, management scheme, and outcome data were analyzed. Sixteen patients underwent delayed laparotomies, whereas 26 patients incurred nontherapeutic laparotomies. Injury severity scores, Glasgow coma scale scores, abdominal abbreviated injury scale score (AIS), and age were similar for both populations. Delayed laparotomies occurred an average of 7 ± 9 days postinjury. Intensive care unit length of stay (26 ± 24 vs 10 ± 6 days), hospital length of stay (40 ± 37 vs 11 ± 10 days), ventilator days (31 ± 29 vs 11 ± 10), and number of abdominal operative procedures (1.9 ± 1.5 vs 1 ± 0) were significantly higher in the delayed laparotomies group versus the nontherapeutic laparotomies group, respectively. Delayed diagnosis of intra-abdominal injuries yielded a significantly increased morbidity and mortality. During the evolving era of technological imaging for traumatic injuries, we must not allow the nonoperative pendulum to swing too far.

scholarly journals Embolization in Trauma: Review of Basic Principles and Techniques

2021 ◽  
Vol 38 (01) ◽  
pp. 018-033
Author(s):  
Jorge E. Lopera
Keyword(s):  
Interventional Radiology ◽  
Cause Of Death ◽  
Paradigm Shift ◽  
Nonoperative Management ◽  
Transcatheter Embolization ◽  
Penetrating Injuries ◽  
Basic Principles ◽  
Traumatic Injuries ◽  
Modern Treatment ◽  
Established Technique

AbstractTrauma is the leading cause of death in patients younger than 45 years. Over the last decade, there has been a progressive paradigm shift toward a nonoperative management of many blunt and penetrating injuries, placing interventional radiology in the forefront in this critical field. Transcatheter embolization is an established technique that plays a significant role in the modern treatment of traumatic injuries of the extremities, pelvis, and solid organs. The purpose of this article is to review the updated principles and techniques used in transcatheter embolization in trauma.

scholarly journals MAIN CONTROVERSIES IN THE NONOPERATIVE MANAGEMENT OF BLUNT SPLENIC INJURIES

2016 ◽  
Vol 29 (1) ◽  
pp. 60-64 ◽  
Author(s):  
Jorge Roberto Marcante CARLOTTO ◽  
Gaspar de Jesus LOPES-FILHO ◽  
Ramiro COLLEONI-NETO
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Splenic Injury ◽  
Nonoperative Management ◽  
Scientific Evidence ◽  
Cochrane Library ◽  
Hemodynamic Stability ◽  
Traumatic Injuries ◽  
Recommendation Grade

Introduction: The nonoperative management of traumatic spleen injuries is the modality of choice in patients with blunt abdominal trauma and hemodynamic stability. However, there are still questions about the treatment indication in some groups of patients, as well as its follow-up. Aim : Update knowledge about the spleen injury. Method: Was performed review of the literature on the nonoperative management of blunt injuries of the spleen in databases: Cochrane Library, Medline and SciELO. Were evaluated articles in English and Portuguese, between 1955 and 2014, using the headings "splenic injury, nonoperative management and blunt abdominal trauma". Results: Were selected 35 articles. Most of them were recommendation grade B and C. Conclusion: The spleen traumatic injuries are frequent and its nonoperative management is a worldwide trend. The available literature does not explain all aspects on treatment. The authors developed a systematization of care based on the best available scientific evidence to better treat this condition.

scholarly journals Delayed and Chronic Sequelae of Trauma and the Role of the Interventional Radiologist

2021 ◽  
Vol 38 (01) ◽  
pp. 131-138
Author(s):  
Robert Wolf ◽  
Sara Smolinski-Zhao
Keyword(s):  
Nonoperative Management ◽  
Imaging Techniques ◽  
Traumatic Injury ◽  
Acute Injury ◽  
Invasive Procedures ◽  
Advanced Imaging ◽  
Chronic Complications ◽  
Traumatic Injuries ◽  
Chronic Sequelae

AbstractIn addition to acute injury requiring interventional radiologic treatments, patients with traumatic injuries can develop delayed or chronic complications. These injuries can involve nearly all solid organs in the abdomen. Coupled with significant improvements in visualizing these injuries with advanced imaging techniques such as minimally invasive procedures, nonoperative management of both acute traumatic injuries and their longer term sequelae has become the norm. This article reviews frequently seen complications of traumatic injury and their management by interventional radiologists.

170: Nonoperative Management of Blunt Renal Trauma: Is Routine Follow-Up Imaging Necessary?

2007 ◽  
Vol 177 (4S) ◽  
pp. 57-58
Author(s):  
John B. Malcolm ◽  
Reza Mehrazin ◽  
Christopher J. DiBlasio ◽  
David D. Vance ◽  
Robert W. Wake ◽  
...  
Keyword(s):  
Nonoperative Management ◽  
Renal Trauma
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