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J Inj Violence Res 2019 Apr 13;11(2). Epub 2019 Apr 13.

Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA. Email:

Injuries to the bladder are infrequent and commonly result from blunt, penetrating, or iatrogenic trauma. Bladder injuries may be missed as they often present concomitantly with other abdominal and pelvic injuries; however, early detection and treatment are essential as morbidity and mortality may be significant. Gross hematuria, especially in the setting of pelvic fractures, may be indicative of a bladder injury which can be confirmed with cystography. Read More

Pediatr Emerg Care 2019 Apr 9. Epub 2019 Apr 9.

Saint Louis School of Medicine, St. Louis.

Objective: Screening blood work after minor injuries is common in pediatric trauma. The risk of missed injuries versus diagnostic necessity in an asymptomatic patient remains an ongoing debate. We evaluated the clinical utility of screening blood work in carefully selected asymptomatic children after minor trauma. Read More

Eur J Trauma Emerg Surg 2019 Apr 4. Epub 2019 Apr 4.

Division of Trauma Surgery, Department of Surgery, Chonnam National University Hospital and Medical School, 42, Jebong-ro, Dong-gu, Gwangju, 61469, Korea.

Purpose: The outcome of cardiopulmonary resuscitation (CPR) after traumatic cardiac arrest is very poor. Moreover, some consider laparotomy for abdominal trauma after CPR futile. This study aimed to investigate the outcomes of trauma patients who were pulseless and received CPR followed by laparotomy. Read More

Am Surg 2019 Mar;85(3):e167-e169

Am Surg 2019 Mar;85(3):292-293

The aim of this study was to characterize the outcomes of traumatic abdominal and pelvic vascular injuries. Using the 2012 National Trauma Data Bank, we identified 5858 patients with major abdominal and/or pelvic vascular injury. Patients were stratified by age group, gender, race, Injury Severity Score (ISS), and mechanism of injury. Read More

Eur J Trauma Emerg Surg 2019 Apr 3. Epub 2019 Apr 3.

Department of Traumatology and Critical Care Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.

Background: Blunt traumatic aortic injury (BTAI) patients are severely ill, with high mortality and morbidity. As 60% of BTAIs occur in the distal arch, left subclavian artery (LSCA) management is determined without knowing posterior cerebral or left arm circulation in emergent cases. Because we perform thoracic endovascular aortic repair (TEVAR) + debranching technique for thoracic BTAI, we assessed efficacy and safety of debranching TEVAR in BTAI patients. Read More

Cureus 2019 Jan 19;11(1):e3922. Epub 2019 Jan 19.

Radiology, Aga Khan University Hospital, Karachi, PAK.

Objective The aim of this study was to describe the outcome of the use of interventional radiological procedures (IRP) (angioembolization) in critically injured children. Methods A retrospective review of medical records of all children who underwent an IRP from January 2010 to December 2015 was done. Data were collected on a structured proforma and results are presented as mean with standard deviation and frequency with percentages. Read More

West Afr J Med 2019 Jan-Apr;36(1):80-82

General Surgery Unit, Department of Surgery, Faculty of Clinical Sciences College of Medicine, University of Lagos & Lagos University Teaching Hospital, PMB 12003, Idi-Araba. Lagos. Nigeria.

Pancreatic pseudocyst (PPC) complicating blunt and penetrating abdominal injury is well documented in paediatric age groups. In adults, PPC is often one of the sequelae of acute pancreatitis rather than trauma. Blunt abdominal trauma accounts for most documented cases of post-traumatic PPC. Read More

J Surg Res 2019 Mar 22;240:60-69. Epub 2019 Mar 22.

Division of Trauma and Critical Care and Acute Care Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina.

Background: Racial, ethnic, and socioeconomic disparities have been shown to exist in trauma patients. Management of blunt splenic injuries (BSIs) can include splenectomy, embolization, or nonoperative management. This study assesses the effect of race and insurance status on outcomes in patients after blunt splenic trauma. Read More

J Thorac Dis 2019 Feb;11(Suppl 2):S177-S185

Unit of Thoracic Surgery, Department of Surgical Sciences, San Giovanni Battista Hospital, University of Torino, Torino, Italy.

Chronic diaphragmatic hernia (CDH) is an uncommon disease which may be associated with significant morbidity and mortality. Antecedent (even many months or years before CDH development) blunt or penetrating thoracic/thoraco-abdominal trauma is generally recognized. A wide spectrum of different mechanisms of injury, timing in presentation, size of the diaphragmatic defect, types and amount of abdominal viscera herniated into the chest cavity, clinical symptoms are observed in CDHs. Read More

J Thorac Dis 2019 Feb;11(Suppl 2):S152-S157

Department of Thoracic & Vascular Surgery, "EVANGELISMOS" General Hospital, Athens, Greece.

The incidence of traumatic diaphragmatic rupture (TDR) is around 0.5% of all trauma patients, located more frequently on the left side (80%), with penetrating trauma being more predominantly the cause (63%) than blunt injuries (37%). TDR typically develops during thoracoabdominal injuries and outcome depends on the severity of the associated organ lesion. Read More

Cureus 2019 Jan 11;11(1):e3870. Epub 2019 Jan 11.

Surgery, Kings College Hospital, London, GBR.

A case of blunt pancreatic trauma during a soccer match is presented in a young adult female. Following diagnosis, a laparotomy was performed and multiple abdominal drains placed. A controlled pancreatic fistula occurred, which was treated conservatively. Read More

JAMA Surg 2019 Mar 20. Epub 2019 Mar 20.

Division of Acute Care Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia.

Importance: The need for improved methods of hemorrhage control and resuscitation has resulted in a reappraisal of resuscitative endovascular balloon occlusion of the aorta (REBOA). However, there is a paucity of data regarding the use of REBOA on a multi-institutional level in the United States.

Objective: To evaluate the outcomes in trauma patients after REBOA placement. Read More

Pediatr Emerg Care 2019 Mar 12. Epub 2019 Mar 12.

Objective: To evaluate the utility of the Point of Care Ultrasound (POCUS) Focused Assessment with Sonography for Trauma (FAST) examination for diagnosis of intra-abdominal injury (IAI) in children presenting with blunt abdominal trauma.

Methods: We searched medical literature from January 1966 to March 2018 in PubMed, EMBASE, and Web of Science. Prospective studies of POCUS FAST examinations in diagnosing IAI in pediatric trauma were included. Read More

Eur J Trauma Emerg Surg 2019 Jan 5. Epub 2019 Jan 5.

School of Medicine, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.

Purpose: Evolving trauma system of Estonia has undergone several reforms; however, performance and outcome indicators have not been benchmarked previously. Thus, we initiated a baseline study to compare demographics, management and outcomes of severely injured patients between Southern Finland and Northern Estonia utilizing regional trauma repositories.

Methods: A comparison of data fields of the Helsinki University Hospital trauma registry (HTR) and trauma registry at the North Estonia Medical Centre in Tallinn (TTR) between 1/1/2015 and 31/12/2016 was performed. Read More

Am Surg 2018 Aug;84(8):e335-e336

Scand J Surg 2019 Mar 4:1457496919833220. Epub 2019 Mar 4.

Abdominal Center, Meilahti Hospital, University of Helsinki, Helsinki, Finland.

Background And Aims:: Today, a significant proportion of solid abdominal organ injuries, whether caused by penetrating or blunt trauma, are managed nonoperatively. However, the controversy over operative versus nonoperative management started more than a hundred years ago. The aim of this review is to highlight some of the key past observations and summarize the current knowledge and guidelines in the management of solid abdominal organ injuries. Read More

Chirurgia (Bucur) 2019 Jan-Feb;114(1):73-82

Diaphragmatic injuries are produced by blunt or penetrating thoracoabdominal trauma. They are potentially life-threatening due to the herniation of abdominal organs into the pleural cavities and severe associated lesions. The aim of this retrospective study was to analyse the clinical presentation and management of patients admitted with diaphragmatic rupture in our institution. Read More

Injury 2019 Mar 14;50(3):697-702. Epub 2019 Feb 14.

Division of Trauma and Acute Care Surgery, University of Southern, Los Angeles, CA, United States.

Introduction: Optimal timing of pharmacological thromboprophylaxis (VTEp) in patients with severe pelvic fractures remains unclear. The high risk of venous thromboembolic (VTE) complications after severe pelvic fractures supports early VTEp however concern for fracture-associated hemorrhage can delay initiation. Patients with pelvic fractures also frequently have additional injuries that complicate the interpretation of the VTEp safety profiles. Read More

Scand J Surg 2019 Feb 20:1457496919828244. Epub 2019 Feb 20.

1 Department of Orthopedics and Traumatology, Trauma Unit, Töölö Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Background And Aims:: Blunt abdominal trauma can lead to substantial organ injury and hemorrhage necessitating open abdominal surgery. Currently, the trend in surgeon training is shifting away from general surgery and the surgical treatment of blunt abdominal trauma patients is often done by sub-specialized surgeons. The aim of this study was to identify what emergency procedures are needed after blunt abdominal trauma and whether they can be performed with the skill set of a general surgeon. Read More

J Pediatr Surg 2019 Jan 22. Epub 2019 Jan 22.

University of Washington, Harborview Injury Prevention and Research Center, 401 Broadway, 4(th) floor, Seattle, WA 98122; University of Washington, Department of Pediatrics, 1959 NE Pacific Street, Box 356320, Seattle, WA 98105. Electronic address:

Background/purpose: Our objective was to evaluate hospital factors, including children's hospital status, associated with higher costs for blunt solid organ pediatric abdominal trauma.

Methods: We queried the 2012 Healthcare Cost and Utilization Project (HCUP) Kid's Inpatient Database (KID) for patients 18 years or younger with low-grade and high-grade blunt abdominal trauma. We calculated total hospital costs and adjusted cost ratios (CR) controlling for patient and hospital-level characteristics. Read More

J Pediatr Surg 2019 Jan 31. Epub 2019 Jan 31.

Division of Pediatric Surgery, University of Tennessee Health Science Center, Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN. Electronic address:

Purpose: The American Pediatric Surgical Association (APSA) guidelines for the treatment of isolated solid organ injury (SOI) in children were published in 2000 and have been widely adopted. The aim of this systematic review by the APSA Outcomes and Evidence Based Practice Committee was to evaluate the published evidence regarding treatment of solid organ injuries in children.

Methods: A comprehensive search strategy was crafted and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were utilized to identify, review, and report salient articles. Read More

Cir Cir 2019 ;87(2):183-189

Servicio de Cirugía Medicina Legal, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, México.

Introduction: Trauma is a leading cause of morbimortality in the world. Intraabdominal compartment is the third most affected anatomical region and bleeding from this origin is difficult to identify, therefore the importance to predict possible lesions to the abdominal cavity.

Objective: To describe and analyze the sociodemographic profile and injuries found in patients with abdominal trauma in a western hospital in Mexico. Read More

Am Surg 2019 Jan;85(1):e34-e35

Am Surg 2019 Jan;85(1):34-38

The incidence of obesity has been increasing in the United States, and the medical care of obese patients after injury is complex. Obesity has been linked to increased morbidity after blunt trauma. Whether increased girth protects abdominal organs from penetrating injury or complicates management from obesity-associated medical comorbidities after penetrating injury has not been well defined. Read More

Curr Treat Options Gastroenterol 2019 Mar;17(1):165-170

Department of Medicine, Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA, USA.

NASN Sch Nurse 2019 May 9;34(3):155-161. Epub 2019 Feb 9.

Professor, Departments of Emergency Medicine and Pediatrics, Penn State College of Medicine.

Illness and injury associated with sport and physical activities may occur in the school setting. Although most sport-related illness and injury in students are considered minor emergencies, life- and limb-threatening illnesses or injuries may occur, such as sudden cardiac arrest, heat stroke, status asthmaticus, catastrophic brain or cervical spine injuries, hypoglycemia, blunt chest/abdominal injuries, or extremity fractures requiring surgery. It is important for the school nurse to recognize potential life- and limb-threatening emergencies associated with sport and physical activity, to initiate stabilization of the student with life- and limb-threatening symptoms, and to triage these students to an appropriate level of care (back to the classroom, home with their guardian with follow up at their primary healthcare provider's office, or directly to the closest emergency department via emergency medical services). Read More

Int J Surg Case Rep 2019 1;55:160-163. Epub 2019 Feb 1.

Department of Surgery, Kendall Regional Medical Center, Miami, FL, United States; University of South Florida, Tampa, FL, United States.

Introduction: Urinary bladder ruptures are an uncommon injury, occurring in less than 1% of all blunt abdominal trauma. Extraperitoneal bladder ruptures are generally associated with pelvic fractures and usually managed nonoperatively. Conversely, intraperitoneal injuries are often caused by large compressive and shear forces produced during seatbelt injuries and almost invariably require surgical intervention. Read More

J Pediatr Surg 2019 Jan 23. Epub 2019 Jan 23.

Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Louisville School of Medicine, 571 S. Floyd St., Suite 802, Louisville, KY 40202. Electronic address:

Background/purpose: The morbidity and mortality of children with traumatic injuries are directly related to the time to definitive management of their injuries. Imaging studies are used in the trauma evaluation to determine the injury type and severity. The goal of this project is to determine if a formal streamlined trauma response improves efficiency in pediatric blunt trauma by evaluating time to acquisition of imaging studies and definitive management. Read More

Am J Case Rep 2019 Feb 7;20:163-166. Epub 2019 Feb 7.

Department of Internal Medicine, United Health Services Hospitals, Wilson Medical Center, Johnson City, NY, USA.

BACKGROUND A clinical condition that is often misdiagnosed, rectus sheath hematoma (RSH) is usually seen in the context of blunt abdominal trauma and/or anticoagulation therapy, rarely occurring spontaneously. We present a case of spontaneous rectus sheath hematoma (SRSH) without obvious risk factors and review the literature regarding diagnosis modalities and management. The aim of this case presentation is to highlight this rare clinical condition and emphasize the role of the physical exam in determining the appropriate treatment approach. Read More

Cureus 2018 Nov 17;10(11):e3604. Epub 2018 Nov 17.

General Surgery, Jinnah Postgraduate Medical College, Karachi, PAK.

Introduction Abdominal injuries are responsible for 10% of the mortalities due to trauma. Delays in early diagnosis or misdiagnoses are two major reasons for the mortality and morbidity associated with abdominal trauma. The objectives of this study were to determine the frequency of visceral injuries in patients with abdominal trauma and compare the frequency of visceral injuries in patients with blunt and penetrating abdominal trauma. Read More

Open Access Emerg Med 2019 7;11:9-13. Epub 2019 Jan 7.

Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran,

Objective: Routine serial hematocrit measurements are a component of the trauma evaluation for patients without serious injury identified on initial evaluation. We sought to determine whether serial hematocrit testing was useful in predicting the probable injuries in blunt abdominal trauma.

Materials And Method: We performed a prospective study of trauma patients admitted in our observation unit over a 12-month period. Read More

Acta Biomed 2019 Jan 15;89(4):505-512. Epub 2019 Jan 15.

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Aim: In our study we investigated characteristics and degree of intra-abdominal solid organ injuries according to tomographic imaging in pediatric patients who presented to our emergency clinic with possible abdominal injuries and to whom US and/or abdominal tomography were applied.

Materials And Methods: 1066 pediatric patients were included in the study. The age, gender, injury localization, injury type, injury mechanism, abdominal US and CT results, and treatment specifics of patients were evaulated. Read More

Emergencias 2019 Ene;31(1):15-20

Servicio de Cirugía General y Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.

Objectives: To describe the abdominal injuries treated in our hospital. We assessed the behavior and reliability of prognostic scales, analyzing the correlations between them and therapeutic decisions and outcomes.

Material And Methods: Retrospective study including all patients with major abdominal injuries admitted to our hospital between 2009 and 2015. Read More

Med J Malaysia 2018 Dec;73(6):425-426

Hospital Kulim, Departmentof Surgery, Jalan Mahang, Kulim, Kedah, Malaysia.

Traumatic abdominal wall hernia (TAWH) after blunt injury is uncommon. Diagnosis requires careful examination and high index of suspicion. We report a case of a 12-year-old boy who complained of painful abdominal swelling over the left iliac fossa after a bicycle-handlebar hit his abdomen. Read More

J Trauma Acute Care Surg 2019 Apr;86(4):642-650

From the Department of Surgery, Reston Hospital Center, Reston, Virginia (S.M.F.); Department of Surgery, Medical University of South Carolina, Charleston, South Carolina (A.A., P.L.F.); Department of Surgery, Inova Fairfax Hospital, Falls Church, Virginia. (C.P.M., A.B.N., C.L.); and Department of Surgery, University of North Carolina, Chapel Hill, NC (M.R.B.).

Background: Previous work demonstrated diagnostic delays in blunt small bowel perforation (SBP) with increased mortality and inability of scans to reliably exclude the diagnosis. We conducted a follow-up multicenter study to determine if these challenges persist 15 years later.

Methods: We selected adult cases with blunt injury, International Classification of Diseases, Ninth Revision or current procedural terminology (CPT) indicating small bowel surgery, no other major injury and at least one abdominal computed tomography (CT) within initial 6 hours. Read More

J Trauma Acute Care Surg 2019 Jan 8. Epub 2019 Jan 8.

Hepatobiliary and Pancreatic Surgery Unit, Level 4, The Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, 4102, QLD.

Background: Extra-hepatic bile duct injuries (EHBDIs) are a rare consequence of blunt abdominal trauma. The purpose of this study was to establish mechanisms of injury, clinical indicators of EHBDI following blunt trauma (both with investigative modalities and intraoperatively), method and timing of injury detection, and definitive treatment options.

Method: A Systematic Review was performed to gather data on patients with an extrahepatic bile duct injury secondary to blunt trauma. Read More

Radiologe 2019 Feb;59(2):139-145

Klinik und Poliklinik für Radiologie, Klinikum der Universität München, Nußbaumstr. 20, 80336, München, Deutschland.

Background: In patients with multiple trauma, abdominal involvement is a particularly relevant injury pattern. Depending on the intensity and manner of injury, heterogeneous but often typical organ manifestations result. Knowledge of these injury patterns is essential for targeted diagnostics and treatment. Read More

Eur J Trauma Emerg Surg 2019 Jan 9. Epub 2019 Jan 9.

Division of Trauma and Emergency Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, No.5, Fuxing St., Guishan Dist., Linkou, Taoyuan, 333, Taiwan.

Purpose: Traumatic subclavian vascular injury (TSVI) is rare but often fatal. The precise diagnosis of TSVI remains challenging mainly because of its occult nature, less typical presentations, and being overlooked in the presence of polytrauma. Compared to penetrating injuries, it is even more difficult to identify TSVI in patients who have blunt injuries and no visible bleeding. Read More

J Belg Soc Radiol 2019 Jan 2;103(1). Epub 2019 Jan 2.

Cliniques St Pierre Ottignies, BE.

Am Surg 2018 Dec;84(12):1869-1875

Two main procedures are performed on patients suffering from colonic perforation, diverting colostomy and primary tissue repair. We investigated patient race, ethnicity, and socioeconomic status (SES) that predicted surgical outcomes after blunt or penetrating trauma. A retrospective analysis was performed using data from the National Trauma Data Bank for three years (2013-2015). Read More

J Trauma Acute Care Surg 2019 Jan;86(1):86-91

From the Department of Surgery, The Children's Hospital at OU Medical Center (P.M.G., P.M, Z.S., R.W.L.), Oklahoma City, Oklahoma; Pediatric Trauma Center, Dell Children's Medical Center (N.M.G., K.A.L., D.W.T.), Austin, Texas; Department of Pediatric Surgery, Children's Healthcare of Atlanta (A.B.), Atlanta, Georgia; Level I Pediatric Trauma Center, Phoenix Children's Hospital (M.E.L., C.S.L., D.M.N., D.J.O.), Phoenix, Arizona; Department of Pediatric Surgery, Arkansas Children's Hospital (R.T.M.), Little Rock, Arkansas; Department of Pediatric Surgery, Le Bonheur Children's Hospital (J.W.E.), Memphis, Tennessee; Pediatric Surgery Department, Children's Medical Center (A.C.A.), Dallas, Texas; Department of Pediatric Surgery, Akron Children's Hospital (T.A.P.), Akron, Ohio; Pediatric Surgery, American Family Children's Hospital (C.W.L.), Madison, Wisconsin; Pediatric Surgery, Mercy Children's Hospital (S.D.S.P.), Kansas City, Missouri.

Background: Focused Abdominal Sonography for Trauma (FAST) examination has long been proven useful in the management of adult trauma patients, however, its utility in pediatric trauma patients is not as proven. Our goal was to evaluate the utility of a FAST examination in predicting the success or failure of nonoperative management (NOM) of blunt liver and/or spleen (BLSI) in the pediatric trauma population.

Methods: A retrospective analysis of a prospective observational study of patients younger than 18 years presenting with BLSI to one of ten Level I pediatric trauma centers between April 2013 and January 2016. Read More

World J Clin Cases 2018 Dec;6(15):1047-1052

Department of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China.

This report describes a 52-year-old male patient with blunt abdominal traumatic rupture of the spleen due to injuries sustained in an automobile accident. Following splenectomy, the patient developed a gastric fistula. He underwent a long period of conservative treatment, including antibiotics and total parenteral nutrition, which was ineffective. Read More

BMJ Case Rep 2018 Dec 10;11(1). Epub 2018 Dec 10.

Surgery, JCHO Chukyo Hospital, Nagoya, Japan.

Rupture of the common bile duct because of blunt trauma is extremely rare. Preoperative diagnosis is very difficult because bile causes little peritoneal irritation. We present a case of a 19-year-old young woman with rupture of the common bile duct due to blunt trauma. Read More

ANZ J Surg 2018 Dec 18. Epub 2018 Dec 18.

Department of General Surgery, Princess Alexandra Hospital, Brisbane, Queensland, Australia.

J Trauma Acute Care Surg 2019 Apr;86(4):565-572

From the Trauma Service (J.M.B., J.B., R.Y.C., M.J.S., L.E.W., W.J.B., C.E.D., C.B.S., V.B.), Scripps Mercy Hospital, San Diego, California.

Background: Outcomes following damage control laparotomy for trauma have been studied in detail. However, outcomes following a single operation, or "single-look trauma laparotomy" (SLTL), have not. We evaluated the association between SLTL and both short-term and long-term outcomes in a large population-based data set. Read More

Urology 2019 Mar 12;125:e1-e3. Epub 2018 Dec 12.

University of Massachusetts Memorial Medical Center, Worcester, MA.

Objective: To describe the presentation of a rare isolated ureteropelvic junction injury resulting from a mechanical fall on ice.

Materials And Methods: A 71-year-old previously healthy man presented to the emergency department at the University of Massachusetts Medical School 3 hours following falling on ice with complaints of gross hematuria and flank pain. Patient records were accessed via the institution's electronic medical records system between March 22, 2018 and April 22, 2018. Read More

Cochrane Database Syst Rev 2018 12 12;12:CD012669. Epub 2018 Dec 12.

Centre for Clinical Research, Department of Trauma and Orthopaedic Surgery, Unfallkrankenhaus Berlin, Berlin, Germany, 12683.

Background: Point-of-care sonography (POCS) has emerged as the screening modality of choice for suspected body trauma in many emergency departments worldwide. Its best known application is FAST (focused abdominal sonography for trauma). The technology is almost ubiquitously available, can be performed during resuscitation, and does not expose patients or staff to radiation. Read More