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Follow-up strategy for early detection of delayed pseudoaneurysms in patients with blunt traumatic spleen injury: A single-center retrospective study

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World Journal of Gastrointestinal Surgery 2024年第10期16卷 3163-3170页

作者： Sung Hoon Cho Gun Woo Kim Suyeong Hwang Kyoung Hoon Lim Department of Surgery Trauma CenterKyungpook National University HospitalSchool of MedicineKyungpook National UniversityDaegu 41944South Korea

BACKGROUND The spleen is the most commonly injured solid organ in blunt abdominal trauma,and splenic pseudoaneurysm rupture is associated with a high risk of *** management has become the standard treatment for hemodynam-ically stable patients with splenic *** the other hand,delayed splenic pseudoaneurysms can develop in any patient,and at present,there are no known risk factors that may reliably predict their ***,there is a lack of consensus regarding the most appropriate strategies for monitoring and mana-ging splenic injuries,especially lower-grade(I-III).AIM To determine the predictors of pseudo-aneurysm formation following splenic injury and develop follow-up strategies for early detection of *** We retrospectively analyzed patients who visited the Level I Trauma Center bet-ween January 2013 and December 2022 and were diagnosed with spleen injuries after blunt abdominal *** Using the American Association for the Surgery of Trauma spleen injury scale,the splenic injuries were categorized into the following order based on severity:Grade I(n=57,17.6%),grade II(n=114,35.3%),grade III(n=89,27.6%),grade IV(n=50,15.5%),and grade V(n=13,4.0%).Of a total of 323 patients,35 underwent splenectomy and 126 underwent angioembolization.19 underwent delayed angioembolization,and 5 under-went both initial and delayed *** 14 patients who had undergone delayed angioembolization,no extravasation or pseudoaneurysm was observed on the initial computed tomography *** are no particular patient-related risk factors for the formation of a delayed splenic pseudoaneurysm,which can occur even in a grade I spleen injury or even 21 days after the *** mean detection time for a delayed pseudoaneurysm was 6.26±5.4(1-21,median:6,inter-quartile range:2-9)*** We recommend regular follow-up computed tomography scans,including an arterial and portal venous phase,at least 1 week an

关键词： Blunt trauma spleen injury Delayed pseudoaneurysm Angioembolization Nonoperative management

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Correlation of rib fracture patterns with abdominal solid organ injury: A retrospective observational cohort study

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Chinese Journal of Traumatology 2022年第1期25卷 45-48页

作者： Abdoulhossein Davoodabadi Noshin Mosavibioki Mohammad Mashayekhil Hamidreza Gilasi Esmail Abdorrahim Kashi Babak Haghpanah Department of Surgery Trauma Research CenterKashan University of Medical SciencesKashanIran General Surgery Department Trauma Research CenterKashan University of Medical SciencesKashanIran Department of Epidemiology&Biostatistics Kashan University of Medical SciencesKashanIran Department of Orthopedic Surgery Kashan University of Medical SciencesKashanIran

Purpose::Rib fractures are one of the most common causes of morbidity and mortality and are associated with abdominal solid organ injury(ASOI).The purpose of this study was to investigate the correlation of ASOI with the number,location,and involved segments of rib fracture(s)in blunt chest ***::This retrospective cohort study was conducted on patients with blunt chest trauma over the age of 15 years,who were hospitalized with the diagnosis of rib fractures from July 2015 to September *** ethic committee approval,a retrospective chart review was designed and patients with a diagnosis of rib fractures were *** who had chest and abdominopelvic CT scan were included in the study and additional data including age,gender,injury severity score,trauma mechanism,number and sides of the fractured ribs(left/right/bilateral),rib fracture segments(upper,middle,lower zone)and results of chest and abdominal spiral CT scan were *** correlation between ASOI and the sides,segments and number of rib fracture(s)was assessed by Pearson's correlation ***::Altogether 1056 patients with rib fracture(s)were *** mean age was(42.76±13.35)years and 85.4%were *** most common mechanism of trauma was car accident(34.6%).Most fractures occurred in the middle rib zone(60.44%)and the most commonly involved ribs were the 6th and 7th ones(15.7%and 16.4%,respectively).Concurrent abdominal injuries were observed in 103 patients(34.91%)and were significantly associated with middle zone rib ***::There is a significant relationship between middle zone rib fractures and ***-abdominal injuries are not restricted to fractures of the lower ribs and thus should always be kept in mind during management of blunt trauma patients with rib fractures.

关键词： Blunt trauma Liver injury Rib fractures Solid organ injury spleen injury

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