scholarly journals Use of Innovative Technologies in the Treatment of Patients with Severe Concomitant Injury with Liver Damage: Clinical Observation

2021 ◽  
pp. 61-63
Author(s):  
A.E. Voynovsky ◽  
◽  
I.A. Semenenko ◽  
A.S. Kuptsov ◽  
◽  
...  
Keyword(s):  
Liver Damage ◽  
Abdominal Trauma ◽  
Clinical Observation ◽  
Damage Control ◽  
Severe Trauma ◽  
Nonoperative Treatment ◽  
Concomitant Injuries ◽  
Innovative Technologies ◽  
Bleeding Management ◽  
Severity Of Injury

Liver injury is one of the most common abdominal injuries in patients with severe trauma. A total of 2988 patients with concomitant injuries were treated at the city clinical hospital named after S.S. Yudin during the period from 2010 to 2020, of which 371 (12.4%) were found to have closed abdominal trauma. Damage to the liver was revealed in 124 (33.4%) patients with closed abdominal trauma. The number of discharged patients was 78 (62,9%), lethal outcome — 46 patients (37,1%). The severity of injury according to ISS was (38,1±11,3) points. The development of innovative multimodal approaches, such as endovascular trauma and bleeding management (EVTM), as well as damage control tactics have significantly increased the likelihood of nonoperative treatment for individual patients. A clinical observation is presented that allows to evaluate the effectiveness of innovative technologies in the treatment of patients with severe concomitant trauma with liver damage.

Analysis of causes and risk factors of lethality of ingured persons with abdominal trauma

2021 ◽  
Vol 42 (2) ◽  
pp. 64-68
Author(s):  
M. О. Gogiya ◽  
Keyword(s):  
Abdominal Trauma ◽  
Injury Severity ◽  
Craniocerebral Trauma ◽  
Severe Trauma ◽  
City Council ◽  
Hospital Treatment ◽  
Care Hospital ◽  
Skeletal Trauma ◽  
Concomitant Injuries ◽  
Results Of Treatment

The study was carried out on the basis of the polytrauma department of the KNP “Municipal Clinical Emergency and Critical Care Hospital named after O. I. Meshchaninov” of Kharkiv City Council. O. I. Meshchaninov” of the Kharkiv City Council. The initial data, results of treatment of 240 victims and their dependence on peculiarities of trauma and peculiarities of victims with abdominal trauma were analysed. Patients with concomitant abdominal trauma predominated in the structure of the injured — 178 (74,2 %), including concomitant injuries of one anatomofunctional area (AFA) in 80 (33,3 %), two AFA– in 67 (27,9 %), and three AFA– in 31 (12,9 %) patients. Isolated abdominal trauma was diagnosed — in 62 (25.9 %) patients. In addition to abdominal injuries, the majority of patients had injuries of other localisations: thoracic trauma — in 129 (53.8 %) patients, skeletal trauma was found — in 96 (40 %) patients, craniocerebral trauma — in 84 (35 %) patients. During in-hospital treatment, 34 (14.2 %) victims died. In the acute period of trauma (1–7 days) 12 (35 %) victims died, including 5 cases within the first day. Lethality was found to increase with the number of injured ASOs, from 4.8 % for isolated abdominal trauma to 41.9 % for additional trauma, thoracic and skeletal trauma (χ2 = 27, 791, p < 0.001), and an increase in injury severity from 7.7 % to 6.7 % for mild to moderately severe trauma to 58.8 % for extremely severe trauma (χ2 = 34.342, p < 0.001) as well as the severity of individual injuries. An increase in lethality was also found with increasing age of the victims and in the presence of increased weight and obesity.

scholarly journals Gastric rupture following blunt abdominal trauma: a case report

2019 ◽  
Vol 6 (10) ◽  
pp. 3869
Author(s):  
Kritika Tiwari ◽  
Anuja Athale ◽  
Siddhartha K.
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Road Traffic Accident ◽  
Traffic Accident ◽  
Road Traffic ◽  
Gastric Perforation ◽  
Abdominal Injuries ◽  
Concomitant Injuries ◽  
Severity Of Injury ◽  
Gastric Rupture

Gastric perforations following blunt abdominal trauma are rare, accounting for <2% of all blunt abdominal injuries. This is usually associated with other solid visceral injuries. Isolated blunt gastric ruptures are very rare. Severity of injury, timing of presentation and presentation following last meal as well as concomitant injuries are important prognostic factors. We present a patient with gastric perforation following road traffic accident.

scholarly journals CLOSED ABDOMINAL INJURY WITH LIVER DAMAGE

2015 ◽  
Vol 174 (1) ◽  
pp. 9-15 ◽  
Author(s):  
B. V. Sigua ◽  
V. P. Zemlyanoy ◽  
A. K. Dyukov
Keyword(s):  
Hepatic Resection ◽  
Liver Damage ◽  
Abdominal Trauma ◽  
Damage Control ◽  
Individualized Treatment ◽  
Abdominal Injury ◽  
Treatment Results ◽  
Primary Suture ◽  
Liver Injuries ◽  
Made In

An analysis of the treatment results was made in 447 patients with closed abdominal injury combined with liver damage. An individualized treatment-and-diagnostic program considering the data of field surgery- MT scale was applied in victims with closed abdominal trauma with liver damage. At the same time the classification E. Moore et.all (1990) for liver injuries was used for assistance. The indications for endovideosurgical homeostasis, a primary suture of liver wound and the hepatic resection were determined. The indications for packing the liver wound were specialized using strategy of «Damage control». An application of given individualized surgical strategy allowed reduction of the lethality level from 32,3% to 17,1% in the case of closed abdominal trauma with liver damage.

scholarly journals LIVER TRANSPLANTATION AFTER SEVERE HEPATIC TRAUMA: CURRENT INDICATIONS AND RESULTS

2015 ◽  
Vol 28 (4) ◽  
pp. 286-289 ◽  
Author(s):  
Marcelo Augusto Fontenelle RIBEIRO-JR ◽  
Melina Botelho MEDRADO ◽  
Otto Mauro ROSA ◽  
Ana Júlia de Deus SILVA ◽  
Mariana Prado FONTANA ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Abdominal Trauma ◽  
Damage Control ◽  
Hypovolemic Shock ◽  
Portacaval Shunt ◽  
Severe Trauma ◽  
Multiple Organ ◽  
Liver Trauma ◽  
Therapeutic Modality ◽  
Study Results

Background: The liver is the most injured organ in abdominal trauma. Currently, the treatment in most cases is non-operative, but surgery may be necessary in severe abdominal trauma with blunt liver damage, especially those that cause uncontrollable bleeding. Despite the damage control approaches in order to achieve hemodynamic stability, many patients develop hypovolemic shock, acute liver failure, multiple organ failure and death. In this context, liver transplantation appears as the lifesaving last resource Aim: Analyze the use of liver transplantation as a treatment option for severe liver trauma. Methods: Were reviewed 14 articles in the PubMed, Medline and Lilacs databases, selected between 2008-2014 and 10 for this study. Results: Were identified 46 cases undergoing liver transplant after liver trauma; the main trauma mechanism was closed/blunt abdominal trauma in 83%, and severe trauma (>grade IV) in 81 %. The transplant can be done, in this context, performing one-stage procedure (damaged organ removed with immediate transplantation), used in 72% of cases. When the two-stage approach is performed, end-to-side temporary portacaval shunt is provided, until new organ becomes available to be transplanted. If two different periods are considered - from 1980 to 2000 and from 2000 to 2014 - the survival rate increased significantly, from 48% to 76%, while the mortality decreased from 52% to 24%. Conclusion: Despite with quite restricted indications, liver transplantation in hepatic injury is a therapeutic modality viable and feasible today, and can be used in cases when other therapeutic modalities in short and long term, do not provide the patient survival chances.

Introduction to the Sixth Edition of the JEVTM

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Igor M. Samokhvalov
Keyword(s):  
Post Partum ◽  
Damage Control ◽  
Interdisciplinary Approach ◽  
Simulation Models ◽  
Balloon Occlusion ◽  
Aortic Aneurysms ◽  
Sixth Edition ◽  
Bleeding Management ◽  
Aortic Balloon Occlusion ◽  
Poster Presentations

Dear Readers, Welcome to the sixth edition of the JEVTM! In 1866, the Great Russian surgeon and scientist Nikolai Pirogov wrote: “A new era for surgery will begin, if we can quickly and surely control the flow in a major artery without exploration and ligation”. This era has now arrived and it is called EVTM! Our mission has been to maximize the benefits of endovascular technologies for trauma and bleeding patients: from the first attempts of REBOA by Carl Hughes in the 1950s with hand-made aortic balloon occlusion catheters used in our department since the early 1990s to modern successful cases of out-of-hospital REBOA use in combat and civilian casualties for ruptured aneurysms, post-partum hemorrhage and trauma. In this edition, you will find articles related to a new strategy of damage control interventional radiology (DCIR), partial REBOA in elderly patients and in ruptured aortic aneurysms, thrombolysis for trauma-associated IVC thrombosis, simulation models for training of REBOA, contemporary utilization of Zone III REBOA and more. As a continuation of EVTM development, Russian surgeons, emergency physicians, anesthetists, and others will be involved in the world of EVTM, participating in expanding the horizons of trauma care and cultivating the endovascular mindset. Also published in this edition are some of the abstracts that will be presented at the EVTM conference in Russia, St. Petersburg (7/06/2019). More than 35 oral and 30 poster presentations will make this conference a scientific feast for our audience! By adopting these new techniques for bleeding management, we are following Pirogov’s motto – to achieve fast endovascular hemorrhage control – which can only be done as part of an interdisciplinary approach.   We look forward to seeing you in Saint Petersburg at the EVTM-Russia meeting! www.evtm.org

Correlation between surgical site infection and obesity after exploratory laparotomy in trauma patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Abdelaziz ◽  
Ahmed Sabry ◽  
Mohamed Fayek
Keyword(s):  
Surgical Site Infection ◽  
Abdominal Trauma ◽  
Damage Control ◽  
Exploratory Laparotomy ◽  
Fascial Closure ◽  
Wound Complications ◽  
Trauma Patients ◽  
Obese Patients ◽  
Site Infection ◽  
University Hospitals

Abstract Background Obesity has become a major contributor to the global burden of chronic disease and disability. Understanding the effect of obesity on the incidence of wound infections and other wound complications remains incomplete despite considerable attention to both the growing ‘‘epidemic’’ of obesity and the frequent occurrence of surgical site infection (SSI) after surgical procedures. Damage-control laparotomy specifically has been associated with a higher rate of infectious complications and a lower rate of primary fascial closure in obese patients. Aim of the work The aim of the study is to evaluate the correlation between obesity and surgical site infection (SSI) in patients undergoing exploratory laparotomy after abdominal trauma. Patients and methods A retrospective study performed on obese patients of both genders aged between 18 and 60 years old undergoing exploratory laparotomy after abdominal trauma at the surgery departments of Ain Shams University Hospitals, Al-Bank Al-Ahly Hospital, Al-Mataria Hospital and Al-Salam Hospital, Cairo, Egypt for two years (1st of January 2018 to 1st of January 2020). Patients with infected wounds, receiving antibiotic therapy at the time of injury, those with a known immunodeficiency, who died within 48 hours after injury, who had sustained burn injuries, who underwent surgery at another institution before admission to our hospital were excluded. The rate of 30-day SSI post-operatively among obese and non-obese patients were compared. Statistical analysis was also done. Results Out of 782 patients, only 480 of those patients for whom BMI data were available, 360 (75%) were males and 120 (25%) were females. Out of the 480 patients: 168 patients had BMI more than 30; 114 patients (67.8%) had SSI (P &lt; 0.05), 312 patients had BMI less than 30; 61 patients (19.5%) had SSI. All of the included patients were fulfilling the inclusion and the exclusion criteria. On multivariate analysis, obesity was the strongest predictor of SSI (odds ratio = 1.59; 95% confidence interval, 1.32-1.91) after adjustment for sex and age. Obese patients with SSI compared with the non-obese had longer hospital stays (mean, 9.5 vs 8.1 days, respectively; P &lt; .001) and markedly higher rates of hospital readmission (27.1% vs 6.5%, respectively; P &lt; .001). Conclusion Obesity is considered as one of the risk factors in causing surgical site infection. Thus, this study showed the relation of BMI and obesity with surgical site infection in case of exploratory laparotomy after abdominal trauma.

DAMAGE CONTROL FOR ABDOMINAL TRAUMA

1997 ◽  
Vol 77 (4) ◽  
pp. 813-820 ◽  
Author(s):  
Asher Hirshberg ◽  
Raphael Walden
Keyword(s):  
Abdominal Trauma ◽  
Damage Control

scholarly journals Combination of ulcerative colitis with cirrhosis of the liver in the outcome of primary sclerosing cholangitis

2020 ◽  
Vol 174 (5) ◽  
pp. 104-107
Author(s):  
A. V. Nikitin ◽  
A. I. Khavkin ◽  
T. A. Skvortsova ◽  
G. V. Volynets ◽  
A. O. Atameeva
Keyword(s):  
Ulcerative Colitis ◽  
Weight Loss ◽  
Primary Sclerosing Cholangitis ◽  
Liver Damage ◽  
Sclerosing Cholangitis ◽  
Clinical Case ◽  
Clinical Observation ◽  
Lower Extremities ◽  
Cirrhosis Of The Liver ◽  
Extraintestinal Manifestation

A clinical case of a combination of ulcerative colitis with cirrhosis in the outcome of primary sclerosing cholangitis in a twelve-year-old child is presented. The uniqueness of the clinical observation lies in the atypical onset of ulcerative colitis in the form of complaints of weakness and headache, as well as detected anemia of 3 severity. It is important that the child lacked diarrhea, blood in the stool, tenesmus, weight loss, and fever. Of the most characteristic signs of liver damage, only itching of the skin of the lower extremities was noted. As a result, the child was diagnosed with cirrhosis of the liver at the end of the extraintestinal manifestation of ulcerative colitis — primary sclerosing cholangitis.

Damage control in severe trauma

2015 ◽  
pp. 323-339
Author(s):  
Michael J. A. Parr ◽  
Ulrike Buehner
Keyword(s):  
Damage Control ◽  
Severe Trauma
Sign in / Sign up

Export Citation Format

Share Document