Hollow organ perforation in blunt abdominal trauma: the role of diagnostic peritoneal lavage Yu-Chun Wang, Chi-Hsun Hsieh, Chih-Yuan Fu, Chun-Chieh Yeh, Shih-Chi Wu, Ray-Jade Chen
DOI: http://dx.doi.org/10.1016/j.ajem.2011.02.014
The American Journal of Emergency Medicine , Vol. 30 , Issue 4 ,
Published online: May 13 2011
x With recent advances in radiologic diagnostic procedures, the use of diagnostic peritoneal lavage (DPL) has markedly declined. In this study, we reviewed data to reevaluate the role of DPL in the diagnosis of hollow organ perforation in patients with blunt abdominal trauma.
Physical examination combined with focused assessment with sonography for trauma examination to clear hemodynamically stable blunt abdominal trauma patients Donald Byars, Alicia Devine, Christopher Maples, Alexander Yeats, Krista Greene
DOI: http://dx.doi.org/10.1016/j.ajem.2013.06.042
The American Journal of Emergency Medicine , Vol. 31 , Issue 10 ,
Published online: September 3 2013
x The use of the focused assessment with sonography for trauma (FAST) examination has become standard practice over the past 10 years in the evaluation of patients with suspected abdominal trauma. It is generally accepted in trauma algorithms as an extension of the physical examination. Currently, it is used primarily to identify the need for an expedited emergency laparotomy in the hemodynamically unstable patient, unable to tolerate a computed tomographic (CT) scan. In hemodynamically stable patients, however, especially those with low-risk injury by history and physical examination, the role of the FAST examination to exclude further diagnostic testing is less studied.
Rate of intra-abdominal injury after a normal abdominal computed tomographic scan in adults with blunt trauma James F. Holmes, John P. McGahan, David H. Wisner
DOI: http://dx.doi.org/10.1016/j.ajem.2011.02.016
The American Journal of Emergency Medicine , Vol. 30 , Issue 4 ,
Published online: June 6 2011
x The objective of this study is to determine the rate of intra-abdominal injury (IAI) in adults with blunt abdominal trauma after a normal abdominal computed tomographic (CT) scan. We hypothesize that the risk of subsequent IAI is so low that hospital admission and observation for possible IAI are unnecessary.
Spontaneous reduction of ileoileal adult intussusception after blunt abdominal injury Mucahit Emet, Abdullah Osman Kocak, Ilker Akbas, Adem Karaman, Sukru Arslan
DOI: http://dx.doi.org/10.1016/j.ajem.2015.07.053
The American Journal of Emergency Medicine , Vol. 33 , Issue 10 ,
Published online: July 28 2015
x This is the first case report of an adult who had spontaneous reduction of ileoileal intussusception occurred after punching to the abdomen. A 40-year-old man was brought to our emergency department by ground ambulance due to pounding and punching a few hours ago. Physical examination showed multiple dermabrasions on his face, abdomen, and lower extremities. All other examinations were unremarkable except that of mild abdominal pain. Laboratory results gave no clues. On abdominal x-ray, paucity of intestinal gas, pseudomass and surrounding gas appearances were visible.
Predictive value of liver transaminases levels in abdominal trauma Ismail Bilgic, Sibel Gelecek, Ali Emre Akgun, M. Mahir Ozmen
DOI: http://dx.doi.org/10.1016/j.ajem.2014.03.052
The American Journal of Emergency Medicine , Vol. 32 , Issue 7 ,
Published online: April 7 2014
x We aimed to evaluate whether hepatic transaminase levels could predict the presence and severity of liver injury following abdominal trauma.
Computed tomography is not justified in every pediatric blunt trauma patient with a suspicious mechanism of injury Yehuda Hershkovitz, Itai Zoarets, Albert Stepansky, Eran Kozer, Zahar Shapira, Baruch Klin, Ariel Halevy, Igor Jeroukhimov
DOI: http://dx.doi.org/10.1016/j.ajem.2014.04.024
The American Journal of Emergency Medicine , Vol. 32 , Issue 7 ,
Published online: April 21 2014
x Computed tomography (CT) has become an important tool for the diagnosis of intra-abdominal and chest injuries in patients with blunt trauma. The role of CT in conscious asymptomatic patients with a suspicious mechanism of injury remains controversial. This controversy intensifies in the management of pediatric blunt trauma patients, who are much more susceptible to radiation exposure. The objective of this study was to evaluate the role of abdominal and chest CT imaging in asymptomatic pediatric patients with a suspicious mechanism of injury.
Real-time 3-dimensional contrast-enhanced ultrasound in detecting hemorrhage of blunt renal trauma Rui-Xue Xu, Ye-Kuo Li, Ting Li, Sha-Sha Wang, Gui-Zhong Yuan, Qun-Fang Zhou, Hai-Rong Zheng, Fei Yan
DOI: http://dx.doi.org/10.1016/j.ajem.2013.06.013
The American Journal of Emergency Medicine , Vol. 31 , Issue 10 ,
Published online: August 21 2013
x The objective of this study is to evaluate the diagnostic value of real-time 3-dimensional contrast-enhanced ultrasound in the hemorrhage of blunt renal trauma.
Intra-abdominal injury is easily overlooked in the patients with concomitant unstable hemodynamics and pelvic fractures Chih-Yuan Fu, Chien-An Liao, Chien-Hung Liao, Shih-Ching Kang, Shang-Yu Wang, Yu-Pao Hsu, Being-Chuan Lin, Kuo-Ching Yuan, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2014.02.013
The American Journal of Emergency Medicine , Vol. 32 , Issue 6 ,
Published online: February 19 2014
x Transcatheter arterial embolization (TAE) is usually necessary in the management of hemodynamically unstable patients with concomitant pelvic fractures. Given the critical conditions of such patients, TAE is at times performed only according to the results of a primary evaluation without computed tomographic (CT) imaging. Therefore, the evaluation of associated intra-abdominal injuries (IAIs) might be insufficient. Clinically, some patients have required post-TAE laparotomy due to further deterioration.
Ability of a new pocket echoscopic device to detect abdominal and pleural effusion in blunt trauma patients Cédric Carrié, François Delaunay, Nicolas Morel, Philippe Revel, Gérard Janvier, Matthieu Biais
DOI: http://dx.doi.org/10.1016/j.ajem.2012.11.008
The American Journal of Emergency Medicine , Vol. 31 , Issue 2 ,
Published in issue: February 2013
x In the early minutes of trauma care, emergency ultrasound can assist the frontline clinician with a goal-directed assessment that can immediately confirm or rule out certain life-threatening conditions and guide the initial resuscitative management in hemodynamically unstable patients [1-3]. To improve the accessibility of ultrasound in emergency and prehospital medicine, a new type of ultra-miniaturized ultrasound device based on 2-dimensional imaging has been recently developed (Fig.). Its true portability and ease of use make real the concept of ultrasonic stethoscope as an extension of the physical examination in various clinical settings [4].
Role of arterial embolization on blunt hepatic trauma patients with type I contrast extravasation Yu-Chun Wang, Chih-Yuan Fu, Yung-Fang Chen, Chi-Hsun Hsieh, Shih-Chi Wu, Chun-Chieh Yeh
DOI: http://dx.doi.org/10.1016/j.ajem.2010.06.001
The American Journal of Emergency Medicine , Vol. 29 , Issue 9 ,
Published online: September 27 2010
x Our aim was to evaluate the clinical effectiveness of transcatheter arterial embolization (TAE) in the management of hemodynamically stable blunt hepatic trauma (BHT) patients with contrast material extravasation into the peritoneal cavity, known as type I contrast material extravasation, on computed tomography (CT) scan.
Hemoperitoneum semiquantitative analysis on admission of blunt trauma patients improves the prediction of massive transfusion Jonathan Charbit, Martin Mahul, Jean-Paul Roustan, Pascal Latry, Ingrid Millet, Patrice Taourel, Xavier Capdevila
DOI: http://dx.doi.org/10.1016/j.ajem.2012.06.024
The American Journal of Emergency Medicine , Vol. 31 , Issue 1 ,
Published online: September 13 2012
x The purpose of this study was to define whether the semiquantitative analysis of hemoperitoneum increases the accuracy of early prediction of massive transfusion (MT).
Benefits of CT tractography in evaluation of anterior abdominal stab wounds Tamer Ertan, Yusuf Sevim, Talha Sarigoz, Omer Topuz, Baki Tastan
DOI: http://dx.doi.org/10.1016/j.ajem.2015.05.018
The American Journal of Emergency Medicine , Vol. 33 , Issue 9 ,
Published online: May 29 2015
x The study aimed to identify the presence of peritoneal penetration in management of anterior abdominal stab wound by using computed tomography (CT) tractography.
The diminishing role of pelvic x-rays in the management of patients with major torso injuries Chih-Yuan Fu, Shang-Yu Wang, Yu-Pao Hsu, Chien-Hung Liao, Being-Chuan Lin, Shih-Ching Kang, Kuo-Ching Yuan, I-Ming Kuo, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.011
The American Journal of Emergency Medicine , Vol. 32 , Issue 1 ,
Published online: October 24 2013
x A pelvic x-ray (PXR) can be used as an effective screening tool to evaluate pelvic fractures and stability. However, associated intra-abdominal/retroperitoneal organ injuries and hemorrhage should also be considered and evaluated in patients with major torso injuries. An abdominal/pelvic computed tomographic (CT) scan may provide higher resolution and more information than a PXR. The role of conventional PXRs was delineated in the current study in the context of the development of the CT scan.
Liver trauma diagnosis with contrast-enhanced ultrasound: interobserver variability between radiologist and emergency physician in an animal study Je Sung You, Yong Eun Chung, Hye-Jeong Lee, Sung Phil Chung, Incheol Park, Myeong-Jin Kim, Mi-Suk Park, Joon Seok Lim, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2011.06.012
The American Journal of Emergency Medicine , Vol. 30 , Issue 7 ,
Published online: August 26 2011
x The purpose of our study was to evaluate interobserver variability between the radiologist and emergency physician in detecting blunt liver trauma by conventional and contrast-enhanced ultrasound (US) (CEUS).
Delayed herniation of intra-abdominal contents after blunt right-sided diaphragm rupture Min-Po Ho, Yuan-Hui Wu, Kaung-Chau Tsai, Jiann-Ming Wu, Wing-Keung Cheung
DOI: http://dx.doi.org/10.1016/j.ajem.2011.12.027
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published online: February 10 2012
x Right diaphragmatic hernia is a rare injury (0.25%-1%) after blunt abdominal trauma. The diagnosis may be delayed and achieved years after the trauma. We currently report a case of a 48-year-old man who presented to the emergency department at Far Eastern Memorial Hospital, New Taipei City, Taiwan, demonstrating signs of herniation of the right diaphragm. The herniation was confirmed using a chest radiograph. The patient reported falling 3 years before the current evaluation and was symptom-free before arrival in the emergency department.
Subject Index
DOI: http://dx.doi.org/10.1016/S0735-6757(12)00518-9
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published in issue: November 2012
Is arterial base deficit still a useful prognostic marker in trauma? A systematic review I. Ibrahim, W.P. Chor, K.M. Chue, C.S. Tan, H.L. Tan, F.J. Siddiqui, M. Hartman
DOI: http://dx.doi.org/10.1016/j.ajem.2015.12.012
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: December 14 2015
x Arterial base deficit (BD) has been widely used in trauma patients since 1960. However, trauma management has also evolved significantly in the last 2 decades. The first objective of this study was to systematically review the literature on the relationship between arterial BD as a prognostic marker for trauma outcomes (mortality, significant injuries, and major complications) in the acute setting. The second objective was to evaluate arterial BD as a prognosis marker, specifically, in the elderly and in patients with positive blood alcohol levels.
Are young physicians prepared to perform focused assessment with sonography in trauma examination? Zenon Truszewski, Lukasz Szarpak, Andrzej Kurowski, Piotr Adamczyk, Silvia Samarin, Lukasz Czyzewski
DOI: http://dx.doi.org/10.1016/j.ajem.2015.10.045
The American Journal of Emergency Medicine , Vol. 34 , Issue 2 ,
Published online: October 30 2015
x In a recent article, O'Dochartaigh and Douma [1] present a systematic review of prehospital ultrasound of the abdomen and thorax, which changes trauma patient management. This article prompted us to conduct a study on young physicians preparing for performing focused assessment with sonography for trauma (FAST).
Spontaneous rupture of spleen masquerading as acute pancreatitis Jyotindu Debnath, Samrat Sonkar, Vivek Sharma, Samar Chatterjee, Vikash Srivastava, Shiv Pankaj Khanna
DOI: http://dx.doi.org/10.1016/j.ajem.2013.10.036
The American Journal of Emergency Medicine , Vol. 32 , Issue 4 ,
Published online: November 25 2013
x Splenic rupture most commonly follows blunt abdominal trauma. Nontraumatic rupture of the spleen is rare. Nontraumatic rupture of the spleen has been described in a variety of pathologic conditions, which include neoplastic, infectious, and hematologic diseases affecting the spleen. Spontaneous rupture of nondiseased spleen is extremely rare. We report a case of spontaneous rupture of spleen in a chronic alcoholic clinically simulating acute pancreatitis.
Elongated left lobe of the liver mimicking a subcapsular hematoma of the spleen on the focused assessment with sonography for trauma exam Robert Jones, Matthew Tabbut, Diane Gramer
DOI: http://dx.doi.org/10.1016/j.ajem.2013.12.050
The American Journal of Emergency Medicine , Vol. 32 , Issue 7 ,
Published online: January 6 2014
x The focused assessment with sonography for trauma examination has assumed the role of initial screening examination for the presence or absence of hemoperitoneum in the patient with blunt abdominal trauma. Sonographic pitfalls associated with the examination have primarily been related to mistaking contained fluid collections with hemoperitoneum. We present a case in which an elongated left lobe of the liver was misdiagnosed as a splenic subcapsular hematoma. It is imperative that emergency physicians and trauma surgeons be familiar with this normal variant of the liver and its associated sonographic appearance on the perisplenic window in order to prevent nontherapeutic laparotomies or embolizations.
