scholarly journals Lesão Visceral em Trauma Abdominal: Um Estudo Retrospetivo

2013 ◽  
Vol 26 (6) ◽  
pp. 725
Author(s):  
Sara Leite ◽  
António Taveira-Gomes ◽  
Hugo Sousa
Keyword(s):  
Abdominal Trauma ◽  
Motor Vehicle ◽  
Penetrating Trauma ◽  
Gunshot Wounds ◽  
Vehicle Collisions ◽  
Revised Trauma Score ◽  
Abdominal Stab Wounds ◽  
Trauma Score ◽  
Pedestrian Collisions ◽  
Clinical File

Background: Abdominal trauma is a major cause of morbi-mortality all over the world which makes it essential an approach focused on rapid diagnosis and treatment. The main goals of this study are to identify global epidemiologic data of abdominal trauma in our tertiary trauma center and to study traumatic lesions, treatment and outcome.Material and Methods: Retrospective analysis of the clinical file of all patients admitted with abdominal trauma, over a period of 5 years, in a tertiary trauma center.Results: the total mean of ages was 42.6 years and the male gender was the most affected (74.2%). At admission, most patients had a Revised Trauma Score > 4. The mainly causes of trauma were blunt from motor-vehicle collisions (39.9% as motor-vehicle occupant and 10.7% from pedestrian collisions) and falls (25.5%). Penetrating trauma, by abdominal stab wounds and gunshot wounds, occurred only in 12.3% of the cases. Hollow visceral injuries were more frequent in that context. In 19.5% of the cases multiple abdominal organinjury occurred. Conservative treatment was performed in 65.3% of the cases. Global mortality was 12%, being null after penetrating lesions.Conclusions: Abdominal trauma, more frequently, is the result of motor-vehicle crashes and falls, being blunt in the majority of the cases. The most affected organs are solid and the approach is conservative. Hollow visceral lesions continue to be of difficult diagnose.

Dual-Energy CT: A Paradigm Shift in Acute Traumatic Abdomen

2020 ◽  
Vol 71 (3) ◽  
pp. 371-387 ◽  
Author(s):  
Saira Hamid ◽  
Savvas Nicolaou ◽  
Faisal Khosa ◽  
Gordon Andrews ◽  
Nicolas Murray ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Trauma ◽  
Motor Vehicle ◽  
Penetrating Trauma ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
Vascular Injuries ◽  
Intravenous Contrast ◽  
Penetrating Abdominal Trauma ◽  
Portable Ultrasound

Abdominal trauma, one of the leading causes of death under the age of 45, can be broadly classified into blunt and penetrating trauma, based on the mechanism of injury. Blunt abdominal trauma usually results from motor vehicle collisions, fall from heights, assaults, and sports and is more common than penetrating abdominal trauma, which is usually seen in firearm injuries and stab wounds. In both blunt and penetrating abdominal trauma, an optimized imaging approach is mandatory to exclude life-threatening injuries. Easy availability of the portable ultrasound in the emergency department and trauma bay makes it one of the most commonly used screening imaging modalities in the abdominal trauma, especially to exclude hemoperitoneum. Evaluation of the visceral and vascular injuries in a hemodynamically stable patient, however, warrants intravenous contrast-enhanced multidetector computed tomography scan. Dual-energy computed tomography with its postprocessing applications such as iodine selective imaging and virtual monoenergetic imaging can reliably depict the conspicuity of traumatic solid and hollow visceral and vascular injuries.

scholarly journals Lesões abdominais nos traumatizados com fraturas de bacia

2002 ◽  
Vol 29 (3) ◽  
pp. 153-160 ◽  
Author(s):  
José Gustavo Parreira ◽  
Luciana Haddad ◽  
Samir Rasslan
Keyword(s):  
Injury Severity Score ◽  
Abdominal Trauma ◽  
Severity Score ◽  
Injury Severity ◽  
Organ Injury ◽  
Abbreviated Injury Scale ◽  
Revised Trauma Score ◽  
Trauma Score

OBJETIVO: Analisar as lesões abdominais e seu impacto no prognóstico dos traumatizados com fraturas de bacia MÉTODO: Avaliamos retrospectivamente todos os prontuários das vítimas de trauma fechado com fraturas de bacia admitidos de 1996 a 2000. Nossa amostra incluiu 224 doentes, com média etária de 34 + 16 anos, sendo 137 (61,1%) do sexo masculino. Dados demográficos, índices de trauma, órgãos lesados, tratamento e evolução foram estudados. As lesões abdominais foram estratificadas pela Organ Injury Scale (OIS), Abbreviated Injury Scale (AIS) e Abdominal Trauma Index (ATI). Empregamos os testes Qui quadrado e t de Student, considerando p<0,05 como significativo. RESULTADOS: O mecanismo de trauma mais comum foi o atropelamento, em 119 casos (53%). As médias dos Revised Trauma Score (RTS) e Injury Severity Score (ISS) foram 7,0341+1,864 e 20,2 + 12,8. As lesões abdominais ocorreram em 95 (42,4%) doentes, sendo a bexiga o órgão mais freqüentemente lesado (11%). Sessenta e três (28,1%) traumatizados tiveram AIS> 3 e 54 (24,1%) OIS > 3 em órgãos abdominais. A média dos ATI foi 9 + 8 nos com lesões abdominais diagnosticadas. Foram realizadas 55 laparotomias (nove não terapêuticas). Cinqüenta e um (22%) doentes morreram, principalmente devido ao choque hemorrágico (25 casos). A presença de lesões abdominais esteve relacionada significativamente com choque à admissão, fraturas complexas de bacia, fixação externa ou interna da fratura de bacia, maior morbidade e letalidade. CONCLUSÃO: As lesões abdominais são freqüentemente associadas às fraturas de bacia, e, quando presentes, relacionam-se a um pior prognóstico.

Traumatic Intracranial Aneurysms in Childhood: Two Cases and a Review of the Literature

Neurosurgery ◽  
1988 ◽  
Vol 22 (2) ◽  
pp. 398-408 ◽  
Author(s):  
Martin J. Buckingham ◽  
Kerry R. Crone ◽  
William S. Ball ◽  
Thomas A. Tomsick ◽  
Thomas S. Berger ◽  
...  
Keyword(s):  
Skull Base ◽  
Intracranial Aneurysms ◽  
Motor Vehicle ◽  
Skull Fracture ◽  
Penetrating Trauma ◽  
Gunshot Wounds ◽  
Male Predominance ◽  
Vehicle Accidents ◽  
Traumatic Aneurysms ◽  
Distal Anterior Cerebral Artery

Abstract Traumatic intracranial aneurysms in childhood are rare. To date, 67 well-documented cases in children have been reported. We present 2 additional cases and review the literature. Traumatic aneurysms can best be categorized based on mechanism of injury and location. Aneurysms secondary to penetrating trauma occur most commonly in teenage boys suffering gunshot wounds. Aneurysms secondary to nonpenetrating trauma occur at the skull base or in the periphery, with motor vehicle accidents and falls as the most common modes of injury. Skull base traumatic aneurysms most commonly involve the petrous, cavernous, or supraclinoid carotid artery and also show a predominance in teenage boys. Peripheral traumatic aneurysms can further be divided into distal anterior cerebral artery aneurysms secondary to trauma against the falcine edge and distal cortical artery aneurysms associated with an overlying skull fracture. Peripheral traumatic aneurysms tend to occur in younger patients with a less marked male predominance. Two-thirds of the patients suffered symptomatic aneurysmal hemorrhage, with an associated mortality rate of 31%. The clinical presentation, diagnosis, and treatment of traumatic intracranial aneurysms are discussed. (Neurosurgery 22:398-408, 1988)

Diagnostic performance of CT and the use of GI contrast material for detection of hollow viscus injury after penetrating abdominal trauma. Experience from a level 1 Nordic trauma center

2020 ◽  
Vol 61 (10) ◽  
pp. 1309-1315
Author(s):  
Sigurveig Thorisdottir ◽  
Gudrun L Oladottir ◽  
Mari T Nummela ◽  
Seppo K Koskinen
Keyword(s):  
Abdominal Trauma ◽  
Contrast Material ◽  
Penetrating Trauma ◽  
Gunshot Wounds ◽  
Hollow Viscus ◽  
Penetrating Abdominal Trauma ◽  
Stab Wounds ◽  
Significant Difference ◽  
Hollow Viscus Injury ◽  
Local Trauma

Background Use of gastrointestinal (GI) contrast material for computed tomography (CT) diagnosis of hollow viscus injury (HVI) after penetrating abdominal trauma is still controversial. Purpose To assess the sensitivity of CT and GI contrast material use in detecting HVI after penetrating abdominal trauma. Material and Methods Retrospective analysis (2013–2016) of patients with penetrating abdominal trauma. Data from the local trauma registry, medical records, and imaging from PACS were reviewed. CT and surgical findings were compared. Results Of 636 patients with penetrating trauma, 177 (163 men, 14 women) had abdominal trauma (mean age 34 years, age range 16–88 years): 155/177 (85%) were imaged with CT on arrival; 128/155 (83%) were stab wounds and 21/155 (14%) were gunshot wounds; 47/155 (30%) had emergent surgery after CT. Two patients were imaged using oral, rectal and i.v. contrast; 23 with rectal and i.v. contrast; and 22 with i.v. contrast only. Surgery revealed HVI in 26 patients. CT had an overall sensitivity 69.2%, specificity 90.5%, PPV 90.0%, and NPV 70.4%. CT with oral and/or rectal contrast (n = 25) had sensitivity 66.7%, specificity 71.4%, PPV 85.7%, and NPV 45.5%. CT with i.v. contrast only (n = 22) had 75% sensitivity, 100% specificity, PPV 100%, and NPV 87.5%. No statistically significant difference was found between sensitivity of CT with GI contrast material and i.v. contrast only ( P = 1). Conclusion Stab wounds were the most common cause of penetrating abdominal trauma. CT had 69.2% sensitivity and 90.5% specificity in detecting HVI. CT with GI contrast had similar sensitivity as CT with i.v. contrast only.

scholarly journals The incidence, spectrum and outcome of paediatric trauma managed by the Pietermaritzburg Metropolitan Trauma Service

2015 ◽  
Vol 97 (4) ◽  
pp. 274-278 ◽  
Author(s):  
V Manchev ◽  
JL Bruce ◽  
GV Oosthuizen ◽  
GL Laing ◽  
DL Clarke
Keyword(s):  
Mortality Rate ◽  
Surveillance System ◽  
Motor Vehicle ◽  
Road Traffic ◽  
Penetrating Trauma ◽  
Trauma Patients ◽  
Vehicle Collisions ◽  
Paediatric Trauma ◽  
Trauma Service ◽  
High Dependency

Introduction The Pietermaritzburg Metropolitan Trauma Service (PMTS) has run a systematic quality improvement programme since 2006. A key component included the development and implementation of an effective surveillance system in the form of an electronic surgical registry (ESR). This study used data from the ESR to review the incidence, spectrum and outcome of paediatric trauma in Pietermaritzburg, South Africa. Methods The ESR was reviewed, and all cases of paediatric trauma managed between 1 January 2012 and 30 July 2014 were retrieved for analysis. Results During the study period, 1,041 paediatric trauma patients (724 male, 69.5%) were managed by the PMTS, averaging a monthly admission of 36. The mean age was 10.9 years (standard deviation: 5.4 years). The mechanism of injury (MOI) was blunt trauma in 753 patients (72.3%) and penetrating trauma in 170 (16.3%). Pedestrian vehicle collisions accounted for 21% of cases and motor vehicle collisions for a further 11%. Intentional trauma accounted for 282 patients (27.1%) and self-inflicted trauma for 14 cases (1.3%). Ninety patients admitted to the intensive care unit and fifty-one required high dependency unit admission. There were 17 deaths, equating to an in-hospital mortality rate of 1.7%. A total of 172 children died on the scene of an incident. There were 35 road traffic related deaths, 26 suicides by hanging, 27 deaths from blunt assault and 23 deaths from penetrating assault. The overall mortality rate for paediatric trauma was 18.2%. Conclusions The ESR has proved to be an effective surveillance system and has enabled the accurate quantification of the burden of paediatric trauma in Pietermaritzburg. This has improved our understanding of the mechanisms and patterns of injury, and has identified a high incidence of intentional and penetrating trauma as well as road traffic collisions. These data can be used to guide strategies to reduce the burden of paediatric trauma in our environment.

Blunt Abdominal Trauma from Motor Vehicle Collisions from 2007 to 2011: Renal Injury Probability and Severity in Children versus Adults

2017 ◽  
Vol 197 (3 Part 2) ◽  
pp. 906-910 ◽  
Author(s):  
Michael P. Kurtz ◽  
Jairam R. Eswara ◽  
Joel M. Vetter ◽  
Caleb P. Nelson ◽  
Steven B. Brandes
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Renal Injury ◽  
Motor Vehicle ◽  
Motor Vehicle Collisions ◽  
Vehicle Collisions ◽  
Injury Probability

scholarly journals Analysis of the Revised Trauma Score (RTS) in 200 victims of different trauma mechanisms

2016 ◽  
Vol 43 (5) ◽  
pp. 334-340 ◽  
Author(s):  
BRUNO DURANTE ALVAREZ ◽  
DANILO MARDEGAM RAZENTE ◽  
DANIEL AUGUSTO MAUAD LACERDA ◽  
NICOLE SILVEIRA LOTHER ◽  
LUIZ CARLOS VON-BAHTEN ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Penetrating Trauma ◽  
Cross Sectional Study ◽  
The Other ◽  
University Hospital ◽  
Cross Sectional ◽  
Revised Trauma Score ◽  
Trauma Victims ◽  
Trauma Score

ABSTRACT Objective: to analyze the epidemiological profile and mortality associated with the Revised Trauma Score (RTS) in trauma victims treated at a university hospital. Methods: we conducted a descriptive, cross-sectional study of trauma protocols (prospectively collected) from December 2013 to February 2014, including trauma victims admitted in the emergency room of the Cajuru University Hospital. We set up three groups: (G1) penetrating trauma to the abdomen and chest, (G2) blunt trauma to the abdomen and chest, and (G3) traumatic brain injury. The variables we analyzed were: gender, age, day of week, mechanism of injury, type of transportation, RTS, hospitalization time and mortality. Results: we analyzed 200 patients, with a mean age of 36.42 ± 17.63 years, and 73.5% were male. The mean age was significantly lower in G1 than in the other groups (p <0.001). Most (40%) of the visits occurred on weekends and the most common pre-hospital transport service (58%) was the SIATE (Emergency Trauma Care Integrated Service). The hospital stay was significantly higher in G1 compared with the other groups (p <0.01). Regarding mortality, there were 12%, 1.35% and 3.95% of deaths in G1, G2 and G3, respectively. The median RTS among the deaths was 5.49, 7.84 and 1.16, respectively, for the three groups. Conclusion: the majority of patients were young men. RTS was effective in predicting mortality in traumatic brain injury, however failing to predict it in patients suffering from blunt and penetrating trauma.

scholarly journals Impact of COVID-19 and Shelter in Place on Volume and Type of Traumatic Injuries

2021 ◽  
Vol 22 (5) ◽  
pp. 1060-1066
Author(s):  
James Murrett ◽  
Emily Fu ◽  
Zoe Maher ◽  
Crystal Bae ◽  
Wayne Satz ◽  
...  
Keyword(s):  
Motor Vehicle ◽  
Penetrating Trauma ◽  
Retrospective Chart Review ◽  
Gunshot Wounds ◽  
Health Crisis ◽  
Traumatic Injuries ◽  
Social Distancing ◽  
Level I ◽  
Novel Coronavirus ◽  
The Impact

Introduction: Very little is known about the effects of the novel coronavirus (COVID-19) pandemic and its associated social distancing practices on trauma presentations to the emergency department (ED). This study aims to assess the impact of a city-wide stay at home order on the volume, type, and outcomes of traumatic injuries at urban EDs. Methods: The study was a retrospective chart review of all patients who presented to the ED of an urban Level I Trauma Center and its urban community affiliate in the time period during the 30 days before the institution of city-wide shelter-in-place (preSIP) order and 60 days after the shelter-in-place (SIP) order and the date-matched time periods in the preceding year. Volume and mechanism of traumatic injuries were compared using paired T-tests. Results: There was a significant decrease in overall ED volume. The volume of certain blunt trauma presentations (motor vehicle collisions) during the first 60 days of SIP compared to the same period from the year prior also significantly decreased. Importantly, the volume of penetrating injuries, including gunshot wounds and stab wounds, did not differ for the preSIP and SIP periods when compared to the prior year. The mortality of traumatic injuries was also unchanged during the SIP comparison period. Conclusion: While there were significant decreases in visits to the ED and overall trauma volume, penetrating trauma, including gun violence, and other severe traumatic injuries remain a public health crisis that affects urban communities despite social distancing recommendations enacted during the COVID-19 pandemic.

scholarly journals Thoracic trauma: analysis of 100 consecutive cases

2010 ◽  
Vol 8 (3) ◽  
pp. 339-342 ◽  
Author(s):  
Maíra Benito Scapolan ◽  
Nathália Lins Pontes Vieira ◽  
Silvia Stiefano Nitrini ◽  
Roberto Saad Junior ◽  
Roberto Gonçalves ◽  
...  
Keyword(s):  
Thoracic Trauma ◽  
Emergency Service ◽  
Cardiac Injury ◽  
Penetrating Trauma ◽  
Young Male ◽  
Probability Of Survival ◽  
Thoracic Drainage ◽  
Revised Trauma Score ◽  
Trauma Injury ◽  
Trauma Score

ABSTRACT Objective: To analyze thoracic trauma assisted by the Emergency Service of Hospital da Irmandade da Santa Casa de Misericórdia de São Paulo. Methods: One hundred patients with thoracic trauma were assisted throughout six months in 2006. Data from their records were collected and a protocol of thoracic trauma was fulfilled. The Revised Trauma Score was used to evaluate gravity of injury and to calculate the survival index. Results: Prevalence of trauma injury in male from 20 to 29 years old was observed. Out of all patients, 44 had blunt trauma and 56 penetrating trauma (78.6% presented stab wounds and 21.4% gun shots). Up to the settings of injuries, 23% were in the thoracoabdominal transition, 7% in the precordium and 70% in the remainder thoracic area. In those with the thoracoabdominal transition injury, 22.7% were hemodynamically unstable and 77.3% stable. Thoracoabdominal injury patients presented 40.9% of diaphragm wound and all were stable. Of those with precordium wound, 37.5% presented cardiac injury. In cardiac onset, 66.7% presented stable and 33.3% unstable. Thoracic drainage was the most accomplished surgical procedure (71%). Conclusions: The thoracic trauma patient is most prevalently young male with stab wound penetrating injury, without associated injuries, hemodynamically stable, presenting hemothorax, with high probability of survival.

A Rare Case of Urinothorax as a Result of Penetrating Trauma

2021 ◽  
pp. 000313482110508
Author(s):  
Casey Connors ◽  
Zaheer Faizi ◽  
Asanthi Ratnasekera
Keyword(s):  
Pleural Fluid ◽  
Motor Vehicle ◽  
Penetrating Trauma ◽  
Motor Vehicle Collisions ◽  
Unique Case ◽  
Vehicle Collisions ◽  
Traumatic Injuries ◽  
Difficult Diagnosis ◽  
Iatrogenic Trauma ◽  
Prolonged Hospital

Urinothorax, defined as urine within the pleural space, is an uncommon finding in published trauma literature. To date, there are less than ten recorded cases of non-iatrogenic trauma-induced urinothorax, most resulting from blunt traumatic injuries from motor vehicle collisions. Given the rarity of the condition, the diagnosis is often missed or delayed. Once the diagnosis is suspected, the most reliable finding is a pleural fluid to serum creatinine ratio of >1. A confirmed diagnosis of urinothorax then requires drainage of pleural fluid and management of distal ureteral obstruction. Unfortunately, the added complexity of the poly-trauma patient obscures this difficult diagnosis often leading to a delay in treatment and prolonged hospital stay. No current published literature exists on penetrating trauma as a cause of urinothorax. Here, we describe a unique case of urinothorax in a 32-year-old male as a result of penetrating trauma.

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