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management of blunt splenic injury in children: evolution of the ...
abstract: background: nonoperative management of blunt splenic injury (bsi) was first proposed at our institution in 1948. since that time, treatment of patients with bsi has evolved from routine splenectomy to an aggressive ...
Observation For Nonoperative Management of the Spleen: How Long is ...
Page: 1354. DOI: 10.1097/TA.0b013e31818e8fde. Authors: McCray, Victor W. MD; Davis, James W. MD; Lemaster, Deborah RN; Parks, Steven N. MD.
World Journal of Emergency Surgery | Full text | Angiography and ...
Emergency laparotomy is the standard treatment for patients with abdominal injury and haemodynamic instability. Over the past twenty years there has been a shift towards non-operative management (NOM) for haemodynamically stable patients without evidence of hollow viscus injury and, ... Splenic embolisation was initially described for haematological indications in the 1970s [11,12] and its use in the management of splenic injury was first reported in the early 1980s [13]. ...
Hepatic & Biliary Trauma. Biliary Tract Injury
BILIARY TRACT INJURY
22. Why are complications associated with bile duct leaks?
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Bilomas (i.e., collections of bile) frequently become infected and may result in lethal peritonitis. Biliopleural fistula, a communication between the biliary system and pleural cavity, persists because of the relative negative pressure in the thorax and may result in a bile empyema.
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biliary trauma, trauma hepatic, biliary tract injury, billiary trauma and its management, fistula biliopleural trauma, hepatic trauma, hepatic trauma and its management, liver trauma and biliary stenting, trauma to biliary tract,Hepatic & Biliary Trauma. Operative Management Of Liver Injury
OPERATIVE MANAGEMENT OF LIVER INJURY
11. How are acute liver injuries classified?
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Liver wounds are generally graded on a scale of I to VI according the depth of parenchymal laceration and involvement of the hepatic veins or retrohepatic portion of the inferior vena cava. Optimal methods of obtaining hemostasis vary with the severity of the injury.
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pringle maneuver technique liver injury, biliary trauma, finger fracture hepatotomy, liver laceration surgical management, liver laceration/pringle maneuver, liver packing, billiary trauma and its management, finger fracture in liver injuries, grading liver lacerations surgical management, hepatic arterial bleeding management, hepatic fracture, hepatic fracture treatment, hepatic trauma and its management, indication hepatic artery ligation, is penrose drain required to provide pringle maneuver, laceration inferior vena cava, liver fracture surgical management, liver hemorrhage maneuver, liver injury-operative steps, liver laceration management, liver packing for trauma, liver packing in trauma, liver trauma-operative steps, management of hepatic trauma, management of liver injuries, management of liver trauma, operative indications liver laceration, operative management of liver injury, operative management of liver trauma bile, option to control liver hemorrhage,Pancreatic & Duodenal Injury
27 PANCREATIC AND DUODENAL INJURY
Caesar M. Ursic M.D.
1. How common are pancreatic injuries?
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The pancreas is not commonly injured because of its protected retroperitoneal position, and thus accounts for only 8% of all penetrating and 2% of all blunt visceral injuries.
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Lower Urinary Tract Injury & Pelvic Trauma
31 LOWER URINARY TRACT INJURY AND PELVIC TRAUMA
Fernando J. Kim M.D., Siam Oottamasathien M.D.
1. What are the causes of bladder injury?
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Iatrogenic manipulation and penetrating or blunt trauma. Because of the rich detrusor blood supply, bladder injury is usually accompanied by hematuria. Other signs may include suprapubic pain, inability to void, or incomplete recovery of catheter irrigation.
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Properties In Evaluation Of The Acute Abdomen. Physical Exam
PHYSICAL EXAMINATION
7. Are vital signs important?
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Yes. They are vital. If heart rate and blood pressure are on the wrong side of 100 (heart rate > 100 beats/min, systolic blood pressure < 100 mmHg), watch out! Tachypnea (respiratory rate >16) reflects either pain or systemic acidosis. Fever may develop late, particularly in the immunosuppressed patient who may be afebrile in the face of florid peritonitis.
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Properties In Evaluation Of The Acute Abdomen
14 PRIORITIES IN EVALUATION OF THE ACUTE ABDOMEN
Alden H. Harken M.D.
1. What is the surgeon’s responsibility when confronted by a patient with an acute abdomen?
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1. To identify how sick the patient is
2. To determine whether the patient (a) needs to go directly to the operating room, (b) should be admitted for resuscitation or observation, or (c) can be sent safely home
Basic Care Of Hand Injuries
34 BASIC CARE OF HAND INJURIES
Michael J.V. Gordon M.D., Lawrence L. Ketch M.D.
1. What are the goals of hand repair?
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Functional considerations override cosmesis in the treatment of hand trauma. There are no minor hand injuries. Initial diagnosis and management determine the final result; expert secondary repair cannot overcome primary errors in diagnosis or decision making.
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Traumatic Brain Injury
18 TRAUMATIC BRAIN INJURY
J. Paul Elliott M.D., Sanjay Misra M.D.
1. Is traumatic brain injury (TBI) a common problem?
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Yes. In the United States, 1 in 12 deaths is due to injury. One third of traumatic deaths are associated with TBI. Of deaths resulting from motor vehicle accidents, 60% are due to brain injury. Even more common is minor TBI, which accounts for 75% of admissions for head trauma.
Intestinal Obstruction Of Neonates & Infants
83 INTESTINAL OBSTRUCTION OF NEONATES AND INFANTS
Richard J. Hendrickson M.D., Denis D. Bensard M.D.
1. What signs or symptoms suggest intestinal obstruction in the neonate?
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Signs and symptoms vary according to the level of obstruction. Proximal intestinal obstruction leads to the early onset of bilious emesis, generally with minimal abdominal distention. In contrast, neonates with distal intestinal obstruction present after the first day of life with bilious vomiting and pronounced abdominal distention. Bilious emesis should always be interrogated further in infants and children.
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j pediatr surg 37:909-911,Surgical Infectious Disease. Management Of Surgical Infections
MANAGEMENT OF SURGICAL INFECTIONS
21. What is the drug of choice for the treatment of an abscess?
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A knife. Surgically drain the abscess. Abscesses have no circulation of blood within them to deliver an antibiotic. The antibiotic, even if injected directly into the abscess, would be worthless because the abscess contains a soup of dead microorganisms and white blood cells (WBCs). Even if the organisms were barely alive, they would not be reproducing and incorporating the antibiotic. The drug most likely would not work at all at the pH and pKa conditions of the abscess environment.
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where there is pus let there be steel, where there is pus let there be steel?, is pus infectious, surgical infectious disease, what does where there is puss let there be steel mean, when there is pus let there be steel, where there is pus there must be steel, where there is puss let there be steel,Risks Of Bloodborne Disease
101 RISKS OF BLOODBORNE DISEASE
Caesar M. Ursic M.D., Doru I. E. Georgescu M.D.
1. What infectious diseases are transmissible via blood transfusion?
Diagnosis & Therapy of Chronic Pancreatitis
41 DIAGNOSIS AND THERAPY OF CHRONIC PANCREATITIS
Clay Cothren M.D., Jon M. Burch M.D.
1. What is chronic pancreatitis?
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The classic syndrome consists of smoldering abdominal pain and evidence of pancreatic insufficiency. Histologically, chronic inflammation results in destruction of the functioning endocrine and exocrine pancreatic cells.
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answers to chronic pancreatitis secondary to alcoholism, http://www ascsurgery com/abstracts/acs/acs0304/htm,Diverticular Disease Of The Colon
48 DIVERTICULAR DISEASE OF THE COLON
Gregory P. Victorino M.D., Jyoti Arya M.D., Lawrence W. Norton M.D.
1. What is a colonic diverticulum?
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A protrusion of mucosa and submucosa through the muscular layers of the bowel wall. It has no muscular covering. Because diverticula do not involve all layers of the bowel wall, they are really “false” diverticula. Diverticulum formation may be related either to weakness of the bowel wall at the sites of vessel perforation or to increased intraluminal pressure caused by low dietary fiber and constipation.
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Congenital Cysts & Sinuses Of The Neck
88 CONGENITAL CYSTS AND SINUSES OF THE NECK
Frederick M. Karrer M.D., Denis D. Bensard M.D.
1. What are branchial cleft anomalies?
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Cysts, sinuses, and fistulas that result from incomplete obliteration of the first, second, or third branchial clefts, and are present in early fetal development.
Hepatic & Biliary Trauma. Surgical Anatomy Of The Liver
SURGICAL ANATOMY OF THE LIVER
7. How many anatomic lobes are present in the liver? What is their topographic boundary?
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The liver is divided into two anatomic lobes, the right and the left. Their boundary lies in an oblique plane extending from the gallbladder fossa anteriorly to the inferior vena cava posteriorly. The three hepatic veins define the division between the lobar segments and the planes of surgical resection. Lobar segments are numbered I-VIII, according to Couinaud’s nomenclature. (See Figure 25-1.)
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Abernathy’s Surgical Secrets, Updated Edition (Book w / Student Consult)
Author / s: Harken Alden H., Abernathy Charles, Moore Ernest Eugene
Year: 2004
Pages: 473
Publishers: Elsevier Mosby; 5th Bk & Acc edition
ISBN: 0323034160
