Study of the occurrence of intra-abdominal hypertension and abdominal compartment syndrome in patients of blunt abdominal trauma and its correlation with the clinical outcome in the above patients
Intra-abdominal pressure (IAP) measurements have been identified as essential for diagnosis and management of both intra-abdominal hypertension (IAH) and Abdominal compartment syndrome (ACS). It has gained pro... (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - February 11, 2016 Category: Emergency Medicine Authors: Ajeet Ramamani Tiwari and Jayashri Sanjay Pandya Source Type: research

Mass casualty incidents - time to engage
Mass casualty incident continues to overwhelm medical systems worldwide. (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - February 3, 2016 Category: Emergency Medicine Authors: Offir Ben-Ishay, Michele Mitaritonno, Fausto Catena, Massimo Sartelli, Luca Ansaloni and Yoram Kluger Source Type: research

Plasma calprotectin level: usage in distinction of uncomplicated from complicated acute appendicitis
The aim of this study was to identify the diagnostic role of plasma calprotectin value for a distinction of presence acute appendicitis and the indifference of uncomplicated from complicated acute appendicitis. (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - January 27, 2016 Category: Emergency Medicine Authors: Murat Cikot, Kivanc Derya Peker, Mehmet Abdussamet Bozkurt, Ali Kocatas, Osman Kones, Sinan Binboga, Asuman Gedikbasi and Halil Alis Source Type: research

Association between increased blood interleukin-6 levels on emergency department arrival and prolonged length of intensive care unit stay for blunt trauma
Systemic immune response to injury plays a key role in the pathophysiological mechanism of blunt trauma. We tested the hypothesis that increased blood interleukin-6 (IL-6) levels of blunt trauma patients on em... (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - January 25, 2016 Category: Emergency Medicine Authors: Masashi Taniguchi, Taka-aki Nakada, Koichiro Shinozaki, Yasuaki Mizushima and Tetsuya Matsuoka Source Type: research

Diagnostic accuracy of oblique chest radiograph for occult pneumothorax: comparison with ultrasonography
An occult pneumothorax is a pneumothorax that is not seen on a supine chest X-ray but is detected by computed tomography scanning. However, critical patients are difficult to transport to the computed tomograp... (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - January 13, 2016 Category: Emergency Medicine Authors: Shokei Matsumoto, Kazuhiko Sekine, Tomohiro Funabiki, Tomohiko Orita, Masayuki Shimizu, Kei Hayashida, Taku Kazamaki, Tatsuya Suzuki, Masanobu Kishikawa, Motoyasu Yamazaki and Mitsuhide Kitano Source Type: research

Global validation of the WSES Sepsis Severity Score for patients with complicated intra-abdominal infections: a prospective multicentre study (WISS Study)
Background: To validate a new practical Sepsis Severity Score for patients with complicated intra-abdominal infections (cIAIs) including the clinical conditions at the admission (severe sepsis/septic shock), the origin of the cIAIs, the delay in source control, the setting of acquisition and any risk factors such as age and immunosuppression. Methods: The WISS study (WSES cIAIs Score Study) is a multicenter observational study underwent in 132 medical institutions worldwide during a four-month study period (October 2014-February 2015). Four thousand five hundred thirty-three patients with a mean age of 51.2 years (ran...
Source: World Journal of Emergency Surgery - December 16, 2015 Category: Emergency Medicine Authors: Massimo SartelliFikri Abu-ZidanFausto CatenaEwen GriffithsSalomone Di SaverioRaul CoimbraCarlos OrdoñezAri LeppaniemiGustavo FragaFederico CoccoliniFerdinando AgrestaAsrhaf AbbasSaleh Abdel KaderJohn AgboolaAdamu AmhedAdesina AjibadeSeckin AkkucukBandar Source Type: research

Acute appendicitis: proposal of a new comprehensive grading system based on clinical, imaging and laparoscopic findings
Advances in the technology and improved access to imaging modalities such as Computed Tomography and laparoscopy have changed the contemporary diagnostic and management of acute appendicitis. Complicated appendicitis (phlegmon, abscess and/ or diffuse peritonitis), is now reliably distinguished from uncomplicated cases. Therefore, a new comprehensive grading system for acute appendicitis is necessary. The goal is review and update the laparoscopic grading system of acute appendicitis and to provide a new standardized classification system to allow more uniform patient stratification. During the last World Society of Emerge...
Source: World Journal of Emergency Surgery - December 3, 2015 Category: Emergency Medicine Authors: Carlos GomesMassimo SartelliSalomone Di SaverioLuca AnsaloniFausto CatenaFederico CoccoliniKenji InabaDemetrios DemetriadesFelipe GomesCamila Gomes Source Type: research

Critically ill patients with acute cholecystitis are at increased risk for extensive gallbladder inflammation
Background: Acute cholecystitis is a common diagnosis and surgery is the standard of care for young and fit patients. However, due to high risk of postoperative morbidity and mortality, surgical management of critically ill patients remains a controversy. It is not clear, whether the increased risk of perioperative complications associated with the management of critically ill patients with acute cholecystitis is secondary to reduced physiologic reserve per se or to the severity of gallbladder inflammation. Methods: A retrospective analysis of prospectively collected data of patients undergoing laparoscopic cholecystectomy...
Source: World Journal of Emergency Surgery - December 1, 2015 Category: Emergency Medicine Authors: Marios PapadakisPeter AmbeHubert Zirngibl Source Type: research

Intra-abdominal hypertension; prevalence, incidence and outcomes in a low resource setting; a prospective observational study
Conclusion: The prevalence and incidence of IAH in the paediatrics and adults group in our study population were high. IAH was associated with mortality in both adult and paediatrics groups and respiratory system dysfunction in adult group. This calls for objective monitoring of intraabdominal pressure in patients undergoing emergency laparotomy with the aim of reducing associated mortality. (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - November 24, 2015 Category: Emergency Medicine Authors: Job KuteesaOlivia KituukaDan NamuguziCynthia NdikunoSamuel KirundaDavid MukunyaMoses Galukande Source Type: research

Massive hemothorax due to inferior phrenic artery injury after blunt trauma
Injury to the inferior phrenic artery after blunt trauma is an extremely rare event, and it may occur under unanticipated conditions. This case report describes an injury to the left inferior phrenic artery caused by blunt trauma, which was complicated by massive hemothorax, and treated with transcatheter arterial embolization (TAE).An 81 year-old female hit by a car while walking at the traffic intersection was transferred to the emergency department, computed tomography scanning revealed active extravasations of the contrast medium within the retrocrural space and from branches of the internal iliac artery. The pati...
Source: World Journal of Emergency Surgery - November 24, 2015 Category: Emergency Medicine Authors: Makoto AokiKei ShibuyaMinoru KanekoAyana KoizumiMasato MurataJun NakajimaShuichi HagiwaraMasahiko KanbeYoshinori KoyamaYoshito TsushimaKiyohiro Oshima Source Type: research

Occult fractures of the proximal femur: imaging diagnosis and management of 82 cases in a regional trauma center
Conclusion: Occult fractures should be suspected in all patients with traumatic onset of hip pain that is inconsistent with normal radiographic findings. MRI is the golden standard but not as readily available not as cheap and not quite as quick to perform as as a CT scan. The latter which in turn can provide falsely negative results in the first 24 h. Improved imaging protocols could expedite management and improve treatment. (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - November 18, 2015 Category: Emergency Medicine Authors: Bogdan DeleanuRadu PrejbeanuEleftherios TsiridisDinu VermesanDan CrisanHoria HaragusVlad PredescuFlorin Birsasteanu Source Type: research

The impact of early surgical intervention in free intestinal perforation: a time-to-intervention pilot study
Conclusions: Literature on the time dependency of early source control is rare and in part contradicting. Results of this pilot study reveal that immediate surgical intervention might be of advantage for septic emergency patients. Further multi-center approaches will be necessary to evaluate, whether the TTI has any impact on the outcome of septic patients with intestinal perforation. (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - November 6, 2015 Category: Emergency Medicine Authors: Andreas HeckerE. SchneckR. RöhrigF. RollerB. HeckerJ. HollerC. KochM. HeckerM. ReichertC. LichtensternG. KrombachW. PadbergM. Weigand Source Type: research

Metallothionein ameliorates burn sepsis partly via activation of Akt signaling pathway in mice: a randomized animal study
Conclusion: MT-2 ameliorates burn sepsis by attenuating inflammatory response and diminishing inflammatory organ damage, which is at least partly mediated by activation of Akt signaling pathway. (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - November 5, 2015 Category: Emergency Medicine Authors: Keqin LuoHuibao LongBincan XuYanling Luo Source Type: research

Gunshot wound without entrance hole: where is the trick? – a case report and review of the literaturer
The presence at CT scan of more retained bullets than expected could be a very difficult interpretation challenge in the early management of gunshot wounds. The modern non operative management of haemodinamically stable patients without peritonitis requires that the trajectory of the bullet is clearly recognized. This clinical case reporting of a gunshot wound without evident entry hole, allows to discuss the diagnostic and therapeutic implications in the management of gunshot wounds cases with atypical entry and/or exit holes. (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - November 4, 2015 Category: Emergency Medicine Authors: Silvia MinistriniGianluca BaiocchiFrida PittianiDaniele LomientoFederico GhezaNazario Portolani Source Type: research

Antibiotics alone versus appendectomy to treat uncomplicated acute appendicitis in adults: what do meta-analyses say?
Conclusion: Based on the current body of evidence, the use of antibiotics for primary treatment of uncomplicated acute appendicitis cannot be routinely recommended. Appendectomy remains the gold-standard treatment. (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - October 31, 2015 Category: Emergency Medicine Authors: Leonardo RochaFelipe RossiCamila PessoaFlavia CamposCarlos PiresMilton Steinman Source Type: research

Transcatheter thrombolysis combined with damage control surgery for treatment of acute mesenteric venous thrombosis associated with bowel necrosis: a retrospective study
Conclusions: Transcatheter thrombectomy/thrombolysis and damage control surgery could help avoid extensive bowel resection, prevent short bowel syndrome and reduce mortality for critically ill patients with acute mesenteric venous thrombosis associated with bowel necrosis. (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - October 29, 2015 Category: Emergency Medicine Authors: Kai LiuJiaxiang MengShuofei YangBaochen LiuWeiwei DingXingjiang WuJieshou Li Source Type: research

WSES position paper on vascular emergency surgery
Trauma, both blunt and penetrating, is extremely common worldwide, as trauma to major vessels. The management of these patients requires specialized surgical skills and techniques of the trauma surgeon. Furthermore few other surgical emergencies require immediate diagnosis and treatment like a ruptured abdominal aortic aneurysm (rAAA). Mortality of patients with a rAAA reaches 85 %, with more than half dying before reaching the hospital. These are acute events demanding immediate intervention to save life and limb and precluding any attempt at transfer or referral.It is the purpose of this position paper to discuss ne...
Source: World Journal of Emergency Surgery - October 22, 2015 Category: Emergency Medicine Authors: Bruno PereiraOsvaldo ChiaraFabio RamponiDieter WeberStefania CimbanassiBelinda De SimoneKorana MusickiGuilherme MeirellesFausto CatenaLuca AnsaloniFederico CoccoliniMassimo SartelliSalomone Di SaverioCino BendinelliGustavo Fraga Source Type: research

Caustic ingestion management: world society of emergency surgery preliminary survey of expert opinion
In this study, we will attempt to review opinions and practices of representatives of the board members of the World Society of Emergency Surgery and compare them to the current literature. (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - October 16, 2015 Category: Emergency Medicine Authors: Yoram KlugerOfir IshayMassimo SartelliAmit KatzLuca AnsaloniCarlos GomezWalter BifflFausto CatenaGustavo FragaSalomone Di SaverioAugustin GoranWagih GhnnamJeffry KashukAri LeppäniemiSanjay MarwahErnest MooreMiklosh BalaDamien MassalouChirica MirceaLuigi Source Type: research

Etiology, treatment outcome and prognostic factors among patients with secondary peritonitis at Bugando Medical Centre, Mwanza, Tanzania
IntroductionSecondary peritonitis due to perforation of the gastrointestinal tract is one of the most common surgical emergencies all over the world and is associated with significantly morbidity and mortality. Previous studies conducted at Bugando Medical Centre (BMC) were retrospective and each was focused on single etiology; therefore there was an obvious need to evaluate the etiologies, treatment outcome and their prognostic factors altogether. Methods: This was a descriptive cross-sectional study involving patients with secondary peritonitis admitted at BMC from May 2014 to April 2015. Sociodemographic and clinical ch...
Source: World Journal of Emergency Surgery - October 6, 2015 Category: Emergency Medicine Authors: Amri MabewaJeremiah SeniPhillipo ChalyaStephen MshanaJaphet Gilyoma Source Type: research

Foregut caustic injuries: results of the world society of emergency surgery consensus conference
Conclusions: The recommendations emerging from this consensus conference, although based on a low level of evidence, have important clinical implications. A world registry of foregut caustic injuries could be useful to collect a homogeneous data-base for prospective clinical studies that may help improving the current clinical practice guidelines. (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - September 26, 2015 Category: Emergency Medicine Authors: Luigi BonavinaMircea ChiricaOgnjan SkrobicYoram KlugerNelson AndreolloSandro ContiniAleksander SimicLuca AnsaloniFausto CatenaGustavo FragaCarlo LocatelliOsvaldo ChiaraJeffry KashukFederico CoccoliniYuri MacchitellaMassimiliano MutignaniCesare CutroneMarc Source Type: research

The importance of open emergency surgery in the treatment of acute mesenteric ischemia
Conclusions: The form of therapy depends on the intraoperative findings and the type of occlusion. Although the mortality rate has decreased in the last decade, in patients over 70 years of age, a significantly worse prognosis was seen. (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - September 26, 2015 Category: Emergency Medicine Authors: Mansur DuranE. PohlK. GrabitzH. SchelzigT. SagbanF. Simon Source Type: research

The limitations of using risk factors to screen for blunt cerebrovascular injuries: the harder you look, the more you find
Conclusions: Our findings demonstrate that reliance on clinical or radiologic risk factors alone as indications for screening for BCVI is inadequate. We recommend routine CTA screening for BCVI in all patients who have sustained a mechanism of injury sufficient to warrant either a CT of the cervical spine or a CTA of the chest. (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - September 26, 2015 Category: Emergency Medicine Authors: Lewis JacobsonMary Ziemba-DavisArgenis Herrera Source Type: research

Evaluation of clotting factor activities early after severe multiple trauma and their correlation with coagulation tests and clinical data
IntroductionTraumatic injuries are amongst the leading causes of death worldwide, frequently as a result of uncontrolled hemorrhage. Critical deficiencies in clotting factors have been noted in trauma-induced coagulopathy. However, the exact underlying conditions that result in devastating coagulopathies remain unclear. The purpose of this study was to elucidate these underlying deficiencies. Methods: Blood samples were drawn from 45 severely injured trauma patients on their arrival at the resuscitation room, and the activities of all soluble clotting factors and routine coagulation tests were assessed. The Mann–Whit...
Source: World Journal of Emergency Surgery - September 22, 2015 Category: Emergency Medicine Authors: Manuel BurggrafArzu PayasMax KautherCarsten SchoenebergSven Lendemans Source Type: research

Epidemiology and socioeconomic features of appendicitis in Taiwan: a 12-year population-based study
Conclusions: Appendicitis and appendectomy in Taiwan had similar overall incidences, seasonality patterns, and declining trends compared to numerous previous studies. Compared to NP patients, LIP patients had a higher risk of appendicitis, longer LOS and higher hospital costs as a result of appendectomy. (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - September 17, 2015 Category: Emergency Medicine Authors: Kai-Biao LinK. LaiNan-Ping YangChien-Lung ChanYuan-Hung LiuRen-Hao PanChien-Hsun Huang Source Type: research

World Society of Emergency Surgery-indication of globalism and renaissance through the 2015 biennial assembly
No description available (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - September 4, 2015 Category: Emergency Medicine Authors: Yoram KlugerFausto CatenaJeffry KashukLuca Ansaloni Source Type: research

Liver trauma: WSES position paper
The liver is the most injured organ in abdominal trauma. Road traffic crashes and antisocial, violent behavior account for the majority of liver injuries. The present position paper represents the position of the World Society of Emergency Surgery (WSES) about the management of liver injuries. (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - August 25, 2015 Category: Emergency Medicine Authors: Federico CoccoliniGiulia MontoriFausto CatenaSalomone Di SaverioWalter BifflErnest MooreAndrew PeitzmanSandro RizoliGregorio TugnoliMassimo SartelliRoberto ManfrediLuca Ansaloni Source Type: research

WSES guidelines for management of Clostridium difficile infection in surgical patients
In the last two decades there have been dramatic changes in the epidemiology of Clostridium difficile infection (CDI), with increases in incidence and severity of disease in many countries worldwide. The incidence of CDI has also increased in surgical patients. Optimization of management of C difficile, has therefore become increasingly urgent. An international multidisciplinary panel of experts prepared evidenced-based World Society of Emergency Surgery (WSES) guidelines for management of CDI in surgical patients. (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - August 20, 2015 Category: Emergency Medicine Authors: Massimo SartelliMark MalangoniFikri Abu-ZidanEwen GriffithsStefano Di BellaLynne McFarlandIan EltringhamVishal ShelatGeorge VelmahosCiarán KellySahil KhannaZaid AbdelsattarLayan AlrahmaniLuca AnsaloniGoran AugustinMiklosh BalaFrédéric BarbutOffir Ben-I Source Type: research

IROA: the International Register of Open Abdomen.: An international effort to better understand the open abdomen: call for participants
Actually the most common indications for Open Abdomen (OA) are trauma, abdominal sepsis, severe acute pancreatitis and more in general all those situations in which an intra-abdominal hypertension condition is present, in order to prevent the development of an abdominal compartment syndrome. The mortality and morbidity rate in patients undergone to OA procedures is still high. At present many studies have been published about the OA management and the progresses in survival rate of critically ill trauma and septic surgical patients. However several issues are still unclear and need more extensive studies. The definitions o...
Source: World Journal of Emergency Surgery - August 16, 2015 Category: Emergency Medicine Authors: Federico CoccoliniFausto CatenaGiulia MontoriMarco CeresoliRoberto ManfrediGabriela NitaErnest MooreWalter BifflRao IvaturyJames WhelanGustavo FragaAri LeppaniemiMassimo SartelliSalomone Di SaverioLuca Ansaloni Source Type: research

Trauma resuscitation requiring massive transfusion: a descriptive analysis of the role of ratio and time
Conclusions: Aggressive attainment of high FFP/PRBC ratios as early as 4 h post-injury can substantially improve outcomes in trauma patients. (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - August 14, 2015 Category: Emergency Medicine Authors: Ruben PeraltaAdarsh VijayAyman El-MenyarRafael ConsunjiHusham AbdelrahmanAshok ParchaniIbrahim AfifiAhmad ZarourHassan Al-ThaniRifat Latifi Source Type: research

The role of the open abdomen procedure in managing severe abdominal sepsis: WSES position paper
The open abdomen (OA) procedure is a significant surgical advance, as part of damage control techniques in severe abdominal trauma. Its application can be adapted to the advantage of patients with severe abdominal sepsis, however its precise role in these patients is still not clear.In severe abdominal sepsis the OA may allow early identification and draining of any residual infection, control any persistent source of infection, and remove more effectively infected or cytokine-loaded peritoneal fluid, preventing abdominal compartment syndrome and deferring definitive intervention and anastomosis until the patient is approp...
Source: World Journal of Emergency Surgery - August 12, 2015 Category: Emergency Medicine Authors: Massimo SartelliFikri Abu-ZidanLuca AnsaloniMiklosh BalaMarcelo BeltránWalter BifflFausto CatenaOsvaldo ChiaraFederico CoccoliniRaul CoimbraZaza DemetrashviliDemetrios DemetriadesJose DiazSalomone Di SaverioGustavo FragaWagih GhnnamEwen GriffithsSanjay G Source Type: research

Surgical management of AAST grades III-V hepatic trauma by Damage control surgery with perihepatic packing and Definitive hepatic repair–single centre experience
Conclusion: All efforts in the treatment of severe liver injuries should be directed to the rapid and effective control of bleeding, because uncontrollable hemorrhage is the cause of early death and it requires massive blood transfusion, all of which contributes to the late fatal complication. (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - August 1, 2015 Category: Emergency Medicine Authors: Krstina Doklesti¿Branislav Stefanovi¿Pavle Gregori¿Nenad Ivan¿evi¿Zlatibor Lon¿arBojan Jovanovi¿Vesna Bumba¿irevi¿Vasilije Jeremi¿Sanja Vujadinovi¿Branislava Stefanovi¿Nata¿a Mili¿Aleksandar Karamarkovi¿ Source Type: research

The selection of diagnostic modalities in the management of pelvic fracture patients requiring transfers
IntroductionPelvic fractures can result in life-threatening hemorrhages. Therefore, pelvic fracture patients must usually be transferred to a trauma center for additional management. We attempted to analyze transferred pelvic fracture patients to determine which diagnostic modalities to use in different treatment settings.Materials and methodsFrom May 1, 2008, to February 28, 2014, patients with pelvic fractures who were transferred from other local hospitals within 24 hours after the trauma were enrolled. We compared the pre-transfer conditions and pelvic X-ray results from the local hospitals between the group of pa...
Source: World Journal of Emergency Surgery - July 30, 2015 Category: Emergency Medicine Authors: Chih-Yuan FuShang-Ju YangChien-Hung LiaoBeing-Chuan LinShih-Ching KangShang-Yu WangYu-Pao Hsu Source Type: research

The open abdomen, indications, management and definitive closure
The indications for Open Abdomen (OA) are generally all those situations in which is ongoing the development an intra-abdominal hypertension condition (IAH), in order to prevent the development of abdominal compartmental syndrome (ACS). In fact all those involved in care of a critically ill patient should in the first instance think how to prevent IAH and ACS. In case of ACS goal directed therapy to achieve early opening and early closure is the key: paradigm of closure shifts to combination of therapies including negative pressure wound therapy and dynamic closure, in order to reduce complications and avoid incisional her...
Source: World Journal of Emergency Surgery - July 25, 2015 Category: Emergency Medicine Authors: Federico CoccoliniWalter BifflFausto CatenaMarco CeresoliOsvaldo ChiaraStefania CimbanassiLuca FattoriAri LeppaniemiRoberto ManfrediGiulia MontoriGiovanni PesentiMichael SugrueLuca Ansaloni Source Type: research

Severe mutilating injuries with complex macroamputations of the upper extremity – is it worth the effort?
Conclusions: Severe and disastrous combined and complex macroamputations of the upper extremity may also have an absolute indication for replantation even though the functional outcome is poor. Not only the feeling of physical integrity can be restored, but the replantation of an amputated upper extremity enables complete or partial recovery of function and sensibility of the arm which is important for the individual. Although our results show a very high DASH-Score, those achievements justify time and person consuming operations. In most cases a replanted extremity is still superior to a secondary allotransplantation. Usu...
Source: World Journal of Emergency Surgery - July 7, 2015 Category: Emergency Medicine Authors: Katrin StangerRaymund HorchAdrian Dragu Source Type: research

Maxillofacial and neck trauma: a damage control approach
Severe maxillofacial and neck trauma exposes patients to life threatening complications such as airway compromise and hemorrhagic shock. These conditions require rapid actions (diagnosis and management) and a strong interplay between surgeons and anesthesiologists. Effective airway management often makes the difference between life and death in severe maxillofacial and neck trauma and takes initial precedence over all other clinical considerations. Damage control strategies focus on physiological and biochemical stabilization prior to the comprehensive anatomical and functional repair of all injuries. Damage control surger...
Source: World Journal of Emergency Surgery - July 7, 2015 Category: Emergency Medicine Authors: Amir KrauszMichael KrauszEdoardo Picetti Source Type: research

Inferior vena cava enteric fistula due to unresected colorectal metastasis
A 57 year old male presented to our department with recurrent attacks of sepsis and upper gastrointestinal bleeding due to colorectal cancer metastasis that resulted in a fistula involving the inferior vena cava and the third part of the duodenum.Four and a half years ago he underwent laparoscopic right hemicolectomy due to colonic adenocarcinoma.A year prior to his recent hospitalization he underwent cytoreductive surgery followed by HIPEC due to peritoneal metastases in another hospital. During the operation a metastasis adherent to the inferior vena cava and the III part of the duodenum was revealed. The surgeon de...
Source: World Journal of Emergency Surgery - July 3, 2015 Category: Emergency Medicine Authors: Hayim GilshteinOffir Ben-IshayKarina NascovicaYoram Kluger Source Type: research

One year experience of swine dermal non-crosslinked collagen prostheses for abdominal wall repairs in elective and emergency surgery
Conclusions: The use of non-cross linked biological meshes can be safe and versatile in different situations from elective to emergency surgery, and also for the reconstruction of the abdominal wall after OA procedure, with an acceptable recurrence and mortality rate. (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - July 1, 2015 Category: Emergency Medicine Authors: Giulia MontoriFederico CoccoliniRoberto ManfrediMarco CeresoliLuca CampanatiStefano MagnoneMichele PisanoElia PoiasinaGabriela NitaFausto CatenaLuca Ansaloni Source Type: research

Focused abdominal sonography for trauma in the clinical evaluation of children with blunt abdominal trauma
The objective of this study was to assess the sensitivity and specificity of FAST for detecting free peritoneal fluid in children. Methods: The trauma registry of a single level I pediatric trauma center was queried for the results of FAST examination of consecutive pediatric ( (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - July 1, 2015 Category: Emergency Medicine Authors: Offir Ben-IshayMai DaoudZvi PeledEran BraunerHany BahouthYoram Kluger Source Type: research

Defining our destiny: trainee working group consensus statement on the future of emergency surgery training in the United Kingdom
The United Kingdom National Health Service treats both elective and emergency patients and seeks to provide high quality care, free at the point of delivery. Equal numbers of emergency and elective general surgical procedures are performed, yet surgical training prioritisation and organisation of NHS institutions is predicated upon elective care. The increasing ratio of emergency general surgery consultant posts compared to traditional sub-specialities has yet to be addressed. How should the capability gap be bridged to equip motivated, skilled surgeons of the future to deliver a high standard of emergency surgical care? T...
Source: World Journal of Emergency Surgery - June 30, 2015 Category: Emergency Medicine Authors: A. SharrockV. GokaniR. HarriesL. PearceS. SmithO. AliH. ChuA. DuboisH. FergusonG. HummM. MarsdenD. NepogodievM. VennS. SinghC. SwainJ. Kirkby-Bott Source Type: research

Prediction of mortality in patients with colorectal perforation based on routinely available parameters: a retrospective study
Conclusions: Older patients and patients with low preoperative blood pressure had a high risk of mortality associated with colorectal perforation. For such patients, operations and postoperative management should be performed carefully. (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - June 25, 2015 Category: Emergency Medicine Authors: Takehito YamamotoRyosuke KitaHideyuki MasuiHiromitsu KinoshitaYusuke SakamotoKazuyuki OkadaJunji KomoriAkira MikiKenji UryuharaHiroyuki KobayashiHiroki HashidaSatoshi KaiharaRyo Hosotani Source Type: research

Microbial colonization of open abdomen in critically ill surgical patients
Conclusions: Microbial colonization of open abdomen is associated with the duration of open abdomen treatment. Wound complications are common after open abdomen, but colonization does not seem to have significant effect on these. The high colonization rate described herein should be taken into account when primarily sterile conditions like acute pancreatitis and aortic aneurysmal rupture are treated with open abdomen. (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - June 25, 2015 Category: Emergency Medicine Authors: Rasilainen KaarinaMentula JuhaniLeppäniemi Kalevi Source Type: research

Prediction of neurosurgical intervention after mild traumatic brain injury using the national trauma data bank
Conclusions: We found that in mild TBI, injury pattern is associated with eventual need for neurosurgical intervention. Patients with cerebral contusion or subarachnoid hemorrhage are much less likely to require neurosurgical intervention, and the effects of age are not significant after controlling for other patient factors. Prospective studies should validate this finding so that treatment guidelines can be updated to better allocate ICU resources. (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - June 6, 2015 Category: Emergency Medicine Authors: Timothy SweeneyArghavan SallesOdette HarrisDavid SpainKristan Staudenmayer Source Type: research

The duration of intra-abdominal hypertension strongly predicts outcomes for the critically ill surgical patients: a prospective observational study
Conclusions: The duration of IAH is a more important prognostic factor than the development of IAH; thus every effort should be made to reduce the IAH duration in critically ill patients.Trial registrationNCT01784458 (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - May 30, 2015 Category: Emergency Medicine Authors: Kyu-Hyouck KyoungSuk-Kyung Hong Source Type: research

Factors affecting morbidity and mortality in traumatic colorectal injuries and reliability and validity of trauma scoring systems
This study aims to determine the factors that affect morbidity and mortality in colon and rectum injuries related with trauma, the use of trauma scoring systems in predicting mortality and morbidity.Patients and methodsBesides patient demographic characteristics, the mechanism of injury, the time between injury and surgery, accompanying body injuries, admittance Glasgow coma scale (GCS), findings at surgery and treatment methods were also recorded. With the obtained data, the abbreviated injury scale (AIS), injury severity score (ISS), revised trauma score (RTS) and trauma-ISS (TRISS) scores of each patient were calculated...
Source: World Journal of Emergency Surgery - May 12, 2015 Category: Emergency Medicine Authors: Nurettin AyVahhaç Alp¿brahim Aliosmano¿luUtkan Sevük¿afak KayaBülent Dinç Source Type: research

Epidemiology of spinal injuries in the United Arab Emirates
AimTo assess the risk factors, mechanism of injury, and clinical outcome of hospitalized patients with spinal injuries in order to recommend preventive measures. Methods: Patients with spinal injuries admitted to Al Ain Hospital, United Arab Emirates (UAE) for more than 24 h or who died after arrival to the hospital were studied over 3 years. Demography, location and time of injury, affected body regions, hospital and ICU stay, and outcome were analyzed. Results: 239 patients were studied, 90 % were males, and 84 % were in the productive years of 25–54. Majority were from the Indian subcontinent (...
Source: World Journal of Emergency Surgery - May 9, 2015 Category: Emergency Medicine Authors: Michal GrivnaHani EidFikri Abu-Zidan Source Type: research

Non operative management of traumatic esophageal perforation leading to esophagocutaneous fistula in pediatric age group: review and case report
Management of delayed presenting esophageal perforations has long been a topic of debate. Most authors consider definitive surgery being the management of choice. Management, however, differs in pediatric patients in consideration with better healing of younger tissues. We extensively review the role of aggressive non-operative management in pediatric esophageal perforations, especially with delayed presentation and exemplify with case of a young boy with esophageal perforation and esophago-cutaneous fistula. We also lay down the protocol to manage such patients based on our institutional recommendations. (Source: World Jo...
Source: World Journal of Emergency Surgery - April 2, 2015 Category: Emergency Medicine Authors: Biplab MishraSaurabh SinghalDivya AggarwalNitesh KumarSubodh Kumar Source Type: research

Benefits of WSES guidelines application for the management of intra-abdominal infections
IntroductionThe use of antibiotics is very high in the departments of emergency and trauma surgery above all in the treatment of the intra-abdominal infections to decrease morbidity and mortality rates but often the antimicrobial drugs are prescribed without a rationale and they are second-line antibiotics; this clinical practice increases costs without decreasing mortality.Aim of our study is to report the results in the application to the clinical practice of the World Society Emergency Surgeons (WSES) guidelines for the management of intra-abdominal infections, at the department of Emergency and Trauma Surgery of the Un...
Source: World Journal of Emergency Surgery - March 18, 2015 Category: Emergency Medicine Authors: Belinda De SimoneFederico CoccoliniFausto CatenaMassimo SartelliSalomone Di SaverioRodolfo CatenaAntonio TarasconiLuca Ansaloni Source Type: research

Laparoscopic surgery in abdominal trauma: a single center review of a 7-year experience
Conclusions: Laparoscopic surgery can be performed safely whether injuries are blunt or penetrating, given hemodynamic stability and proper technique. Patients may thus benefit from the shorter hospital stays, greater postoperative comfort (less pain), quicker recoveries, and low morbidity/mortality rates that laparoscopy affords. (Source: World Journal of Emergency Surgery)
Source: World Journal of Emergency Surgery - March 12, 2015 Category: Emergency Medicine Authors: Kyoung LimBong ChungJong KimSung Kim Source Type: research

Non-heparinized ECMO serves a rescue method in a multitrauma patient combining pulmonary contusion and nonoperative internal bleeding: a case report and literature review
Pulmonary contusion and acute respiratory distress syndrome (ARDS) is a common manifestation in polytraumatic patients. Although mechanical ventilation is still the first choice of treatment, a group of patients are still unable to maintain their oxygenation. The role of extracorporeal membrane oxygenation (ECMO) has been more clarified when the lung is extensively damaged and when conventional modality failed. ECMO provides the lung an opportunity to rest by permitting reduced ventilator settings and limiting further barotraumas. However, ECMO is still considered contraindicated in polytramatic patients combining pulmonar...
Source: World Journal of Emergency Surgery - March 12, 2015 Category: Emergency Medicine Authors: Pei-Hung WenWai ChanYing-Cheng ChenYao-Li ChenChien-Pin ChanPing-Yi Lin Source Type: research

Iatrogenic ureteric injuries following abdomino-pelvic operations: a 10-year tertiary care hospital experience in Tanzania
This study describes our experience in the management and outcome of ureteric injuries following abdomino-pelvic operations outlining the causes, clinical presentation and outcome of management of this condition in our local setting. Methods: This was a retrospective descriptive study of patients with iatrogenic ureteric injuries following abdomino-pelvic operations that were managed in Bugando Medical Centre between July 2004 and June 2014. Results: A total of 164 patients (M: F = 1: 1.6) were studied. Of these, 154 (93.9%) were referred to Bugando Medical Centre having had their initial surgeries performed ...
Source: World Journal of Emergency Surgery - March 12, 2015 Category: Emergency Medicine Authors: Phillipo ChalyaAnthony MassindeAlbert KihunrwaSamson Simbila Source Type: research