European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Aug 2022
Preoperative findings on non-specific CT in patients with primary acute intestinal ischemia: a case-control study.
Primary acute intestinal ischaemia (AII) is an abdominal catastrophe caused by intravascular obstruction of blood supply. It is difficult to diagnose. Computerized tomography (CT) scan is the modality of choice for diagnostic evaluation. Majority of previous studies have evaluated CT findings in patients where AII was suspected. However, unveiling the unique radiological findings also in not initially suspected AII patients, might lead to the timely management of AII patients, and is the aim of this study. ⋯ Radiological changes within the intestinal wall, luminal diameter and gastrointestinal vessels are independent predictors of AII. Awareness of these radiological findings, therefore, plays a central role in patients with an indistinct clinical picture in early recognition and treatment of a life-threatening AII.
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Hip hemiarthroplasty (HA) is a commonly performed operation. A post-operative radiograph forms part of the routine hip fracture pathway, although patients are often mobilised prior to this investigation. This study seeks to provide evidence for a pragmatic clinical change to optimise patient safety and allocate limited resources within the National Health Service (NHS). ⋯ Unless a patient is pre-morbidly bed bound and cognitively impaired, routine post-operative radiography following HA surgery is of little clinical benefit, yet may carry considerable risk to the patient and cost to the NHS. A pragmatic compromise is to perform intra-operative fluoroscopic imaging.
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Eur J Trauma Emerg Surg · Aug 2022
Multicenter StudySurgical stabilization versus nonoperative treatment for flail and non-flail rib fracture patterns in patients with traumatic brain injury.
Literature on outcomes after SSRF, stratified for rib fracture pattern is scarce in patients with moderate to severe traumatic brain injury (TBI; Glasgow Coma Scale ≤ 12). We hypothesized that SSRF is associated with improved outcomes as compared to nonoperative management without hampering neurological recovery in these patients. ⋯ In patients with TBI and a non-flail fracture pattern, SSRF was associated with a reduced pneumonia risk. In patients with TBI and a flail chest, a shorter ICU LOS was observed in the SSRF group. In both groups, SSRF was safe and did not hamper neurological recovery.