scholarly journals Case Report of a Laparoscopic Primary Diaphragmatic Repair in Acute Penetrating Trauma: Is It Within the Realm of an Acute Care Surgeon?

2021 ◽  
Vol 11 (2) ◽  
pp. 78-81
Author(s):  
Yagan Pillay ◽  
Cheyenne Vetter
2021 ◽  
Vol 32 ◽  
pp. 100421
Author(s):  
David A. Cardenas ◽  
Cristian G. García ◽  
Cristhian García ◽  
Jose L. Moreno ◽  
Milton O. Sandoval ◽  
...  

2014 ◽  
Vol 28 (3) ◽  
pp. 27-34 ◽  
Author(s):  
Melissa Bednarek ◽  
Patricia Downey ◽  
Ann Williamson ◽  
Carol Ennulat

2019 ◽  
Vol 34 (s1) ◽  
pp. s109-s109
Author(s):  
Tracie Jones

Introduction:Electronic Dance Music events (EDMs) are complex mass gatherings and given published rates of illnesses, injuries, and hospitalizations, these events can place an additional burden on local health care services. Accordingly, during the planning process for EDMs many stakeholders are involved; however, local hospitals, a key part of the medical safety plan, are often excluded. In this case report, it is posited that the involvement of local hospital(s) and the resulting integration of on-site and acute-care service provision during an event, ultimately reduces the burden placed on local hospitals.Methods:Case report; synthesis of published literature.Results:A 25,000 person per day, two-day mass gathering EDM event trialed a model of collaborative planning with a local community hospital. Planning included the identification of a hospital liaison, pre-event teleconferences between event staff, contracted and public medical response teams, emergency management teams, harm reduction practitioners, public health, and hospital personnel. Throughout the collaborative planning process, vital information was shared in order to optimize patient continuity of care and streamline the transition of care from site medical response to an acute care setting. Outcomes included the prevention of unnecessary transfers to the hospital; however, those patients who required transfer had their initial treatment started prior to leaving the venue. Further, collaborative planning also contributed to improved bidirectional data sharing to better understand the impact on the local hospital of the event, including transfers from the onsite medical team as well as transports from the community and self-presentations for care.Discussion:The collaboration of onsite medical and hospital teams improved the delivery of essential medical care to the patrons of the event and added a layer to the safety planning process essential to mass gathering events.


2020 ◽  
Vol 48 (6) ◽  
pp. 030006052093086
Author(s):  
Jian-Chun Xiao ◽  
Li-Yuan Ma ◽  
Bing-Lu Li

Traumatic diaphragmatic rupture (TDR) is an uncommon but life-threatening condition often caused by blunt or penetrating trauma. Symptoms may appear late resulting in delayed or missed diagnosis. We report here a case of a 28-year-old man who presented with left subcostal pain and vomiting after recently binge drinking alcohol. He had experienced bilateral rib fractures two years previously. Computed tomography (CT) showed massive left pleural effusion and pleural fluid drained by thoracentesis had a bloody appearance. The patient developed septic shock but emergency surgery showed no active bleeding. Enhanced-CT showed herniated stomach with ischemic necrosis in the left thoracic cavity. Total gastrectomy and diaphragmatic repair were successful and the patient had an uneventful recovery. A high index of suspicion is necessary when evaluating haemothorax, especially in patients with recent or previous thoraco-abdominal injury.


2020 ◽  
Vol 86 (5) ◽  
pp. 493-498
Author(s):  
Haris H. Chaudhry ◽  
Areg Grigorian ◽  
Michael E. Lekawa ◽  
Matthew O. Dolich ◽  
Ninh T. Nguyen ◽  
...  

Background Isolated diaphragm injury (IDI) occurs in up to 30% of penetrating left thoracoabdominal injuries. Laparoscopic abdominal procedures have demonstrated improved outcome including decreased postoperative pain and length of stay (LOS) compared to open surgery. However, there is a paucity of data on this topic for penetrating IDI. The aim of this study was to examine the prevalence and outcome of laparoscopic diaphragmatic repair versus open diaphragmatic repair (LDR vs ODR) of IDI. Methods The Trauma Quality Improvement Program (2010-2016) was queried for patients with IDI who underwent ODR versus LDR. A bivariate analysis using Pearson chi-square and Mann-Whitney test was performed to determine LOS among the two groups. Results From 2039 diaphragm injuries, 368 patients had IDI; 281 patients (76.4%) underwent ODR and 87 (23.6%) underwent LDR. Compared to LDR, the ODR patients were older (median, 31 vs 25 years, P < .001) and had a higher injury severity score (mean, 11.2 vs 9.6, P = .03) but had similar rates of intensive care unit LOS, unplanned return to the operating room, ventilator days, and complications ( P > .05). Patients undergoing ODR had a longer LOS (5 vs 4 days, P = .01), compared to LDR. There were no deaths in either group. Conclusions Trauma patients presenting with IDI undergoing ODR had a longer hospital LOS compared to patients undergoing LDR with no difference in complications or mortality. Therefore, we recommend when possible an LDR should be employed to decrease hospital LOS. Further research is needed to examine other benefits of laparoscopy such as postoperative pain, incisional hernia, and wound-related complications.


2009 ◽  
Vol 2009 ◽  
pp. 1-4 ◽  
Author(s):  
Michael Moncure ◽  
Jared A. Konie ◽  
Adam B. Kretzer ◽  
Peter J. DiPasco ◽  
Carla C. Braxton

Impalement injuries are a unique form of penetrating trauma and are typically associated with a fall onto the object (Steele, 2006). We present the case of a 45-year-old man who reportedly slipped in his bathtub and fell onto a broomstick. Radiographic examination revealed a slender mass extending from his rectum to the right side of his neck. A review of English literature suggests that this is the second reported case in the last 100 years describing the successful management of an impalement injury traversing the pelvic, abdominal, and thoracic cavities. The management of this case is described.


2012 ◽  
Vol 75 (S1) ◽  
pp. 428-429 ◽  
Author(s):  
Sartaj Singh Sandhu ◽  
Sunil K Sampley ◽  
Kapil Chhabra

2008 ◽  
Vol 24 (8) ◽  
pp. 422-424 ◽  
Author(s):  
Turgay Akgül ◽  
Erim Ersoy ◽  
Osman Polat ◽  
Tolga Karakan ◽  
Cankon Germiyanoĝlu

2017 ◽  
Vol 69 (4) ◽  
pp. 318-322
Author(s):  
Sarah Wojkowski ◽  
Janelle Unger ◽  
Magda McCaughan ◽  
Beverley Cole ◽  
Michelle E. Kho

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