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Int J Surg Case Rep 2020 May 11;71:159-162. Epub 2020 May 11.

Department of Surgery and Anesthesiology, Moi University, School of Medicine, Eldoret, Kenya; Department of Cardiothoracic Surgery, Moi Teaching and Referral Hospital, Eldoret, Kenya.

Introduction: Mortality after esophageal perforation is high irrespective of the treatment modality. The rarity of traumatic esophageal perforations has made it difficult to conduct comprehensive studies that can answer pertinent questions with regard to management.

Presentation Of Case: We report a case of through and through thoracic esophageal injury caused by an assailant's arrow in a young physically active male adult. Read More

Ann Am Thorac Soc 2020 May 18. Epub 2020 May 18.

Beth Israel Deaconess Medical Center, 1859, Division of Thoracic Surgery and Interventional Pulmonology, Boston, Massachusetts, United States;

Rationale: Pleural infection is a frequent diagnosis encountered in clinical practice associated with high morbidity and mortality. Limited evidence exists regarding the optimal treatment. Although both early medical thoracoscopy (MT) and tube thoracostomy with intrapleural instillation of tissue plasminogen activator (tPA) and human recombinant deoxyribonuclease (DNase) are acceptable treatment for patients with complicated pleural infection, there is a lack of comparative data between these modes of management. Read More

Chin J Traumatol 2020 Apr 20. Epub 2020 Apr 20.

Gulhane Medical School, University of Health Sciences, Ankara, Turkey.

Physical traumas are tragic and multifaceted injuries that suddenly threaten life. Although it is the third most common cause of death in all age groups, one out of four trauma patients die due to thoracic injury or its complications. Blunt injuries constitute the majority of chest trauma. Read More

Trauma Surg Acute Care Open 2020 30;5(1):e000498. Epub 2020 Apr 30.

Department of Surgery, Inova Fairfax Medical Center, Falls Church, Virginia, USA.

This document provides guidance for trauma and acute care surgeons surrounding the placement, management and removal of chest tubes during the COVID-19 pandemic. Read More

Medicine (Baltimore) 2020 Apr;99(16):e19869

Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, Jung-gu, Incheon, South Korea.

Introduction: Klebsiella pneumoniae liver abscess (KPLA) is often associated with accompanying metastatic complications such as septic pulmonary embolism, brain abscess, and endophthalmitis. Pleural empyema secondary to a KPLA is a very unusual finding, made even more rare with the presence of a hepatopleural fistula.

Patient Concerns: An 81-year-old woman presented with aggravated dyspnea. Read More

JAMA Netw Open 2020 Mar 2;3(3):e201316. Epub 2020 Mar 2.

Institute for Health Informatics, University of Minnesota Academic Health Center, Minneapolis.

Importance: Rib fractures are sustained by nearly 15% of patients who experience trauma and are associated with significant morbidity and mortality. Evidence-based practice (EBP) rib fracture management guidelines and treatment algorithms have been published. However, few studies have evaluated trauma center adherence to EBP or the clinical outcomes of each practice within a national cohort. Read More

Qatar Med J 2020 16;2020(1):10. Epub 2020 Mar 16.

Department of Surgery, Trauma Surgery Section, Hamad Medical Corporation, Doha, Qatar.

We aimed to assess the management and outcome of occult pneumothorax and to determine the factors associated with failure of observational management in patients with blunt chest trauma (BCT). Patients with BCT were retrospectively identified from the trauma database over 4 years. Data were analyzed and compared on the basis of initial management (conservative vs. Read More

Trauma Case Rep 2020 Apr 25;26:100294. Epub 2020 Feb 25.

Community Mental Health, Trelawny Health Services, Western Regional Health Authority, 1S, Montego Bay, St. James, Jamaica.

There are very few reports in the literature about clavicular fractures being associated with a pneumothorax. With this combination of injuries, there are also minimal reports of a delayed presentation of a pneumothorax. This is the first report of a delayed pneumothorax followed by a recurrence of a pneumothorax due to the fractured ends of the clavicle. Read More

Clin Pract Cases Emerg Med 2020 Feb 21;4(1):90-91. Epub 2020 Jan 21.

São Paulo University, Department of Emergency Medicine, São Paulo, Brazil.

Pigtail catheters have emerged as an effective and less morbid alternative to traditional chest tubes for evacuation of pleural air. Rare complications in the literature have been reported. We report a case of a 92-year-old male who presented with dyspnea and shock, noted to have a pneumothorax requiring tube thoracostomy. Read More

Clin Pract Cases Emerg Med 2020 Feb 21;4(1):21-25. Epub 2020 Jan 21.

Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York.

This is a case series of six emergency department (ED) patients who received an ultrasound-guided serratus anterior plane block (SAPB) for a variety of painful conditions. Our cases illustrate the feasibility and analgesic efficacy of the SAPB in providing pain management in ED patients with a variety of painful syndromes, including those with severe pain from multiple rib fractures, herpes zoster, and tube thoracostomy placement. In addition, we found no adverse events in our case series. Read More

J Surg Res 2020 Jun 7;250:135-142. Epub 2020 Feb 7.

Division of Pediatric Surgery, Department of Surgery, University of Massachusetts Medical School, Worcester, Massachusetts.

Background: Few studies have analyzed pediatric spontaneous pneumothorax (SPTX) nationally. We sought to better define this patient population and explore the evolution of surgical management.

Methods: Patients (10-20 y old) with an International Classification of Diseases, Ninth Revision diagnosis of SPTX were identified within the Kids' Inpatient Database for the years 2006, 2009, and 2012. Read More

Cureus 2019 Dec 6;11(12):e6306. Epub 2019 Dec 6.

Anatomy, Quetta Institute of Medical Sciences, Quetta, PAK.

Introduction: Thoracic injury is becoming an important cause of mortality in Pakistan, especially in the younger subset of population. The initial management of these injuries is essential as these patients can develop multiple complications, ultimately leading to death of the patients.

Materials And Methods: This prospective observational study was carried out from January 2016 to December 2018 at the Department of Surgery, Holy Family Hospital, Rawalpindi Medical University, Pakistan. Read More

Indian J Occup Environ Med 2019 Sep-Dec;23(3):112-116. Epub 2019 Dec 16.

Department of Chest and TB, Institute of Respiratory Disease, SMS Medical College, Jaipur, Rajasthan, India.

Background And Aims: Silicosis is an occupational lung disease caused by inhalation of crystalline silica. People working in occupations like sandblasting, surface drilling, tunnelling, silica flour milling, ceramic making are predisposed to develop silicosis. Unilateral spontaneous pneumothorax is a pleural complication that can develop in such cases. Read More

EJVES Short Rep 2020 9;46:2-4. Epub 2019 Dec 9.

Stony Brook University Medical Center, Department of Surgery, Division of Vascular and Endovascular Surgery, Stony Brook, NY, USA.

Background: Aortic injuries during non-aortic related procedures are rare but potentially catastrophic. Endovascular aortic repair has been described as a viable option in similar circumstances. However, most reports involve aortic injury from orthopaedic hardware after spine surgery or trocar injury during abdominal surgery. Read More

Surg Case Rep 2019 Dec 11;5(1):195. Epub 2019 Dec 11.

Department of Esophageal Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.

Background: Management of postoperative chylothorax usually consists of nutritional regimens, pharmacological therapies such as octreotide, and surgical therapies such as ligation of thoracic duct, but a clear consensus is yet to be reached. Further, the variation of the thoracic duct makes chylothorax difficult to treat. This report describes a rare case of chylothorax with an aberrant thoracic duct that was successfully treated using focal pleurodesis through interventional radiology (IVR). Read More

J Trauma Acute Care Surg 2020 Feb;88(2):249-257

From the Department of Surgery, Division of Trauma, Denver Health Medical Center (F.M.P., K.L.), Denver Colorado; Department of Surgery, Division of Trauma, University of Nebraska Medical Center (Z.B.), Omaha, Nebraska; Department of Surgery, Division of Trauma, Medical University of South Carolina (E.A.E.), Charleston, South Carolina; Department of Surgery, Division of Trauma, St. Mary's Medical Center (L.L.), West Palm Beach, Florida; Department of Surgery, Division of Trauma, Intermountain Medical Center (S.M.), Murray, Utah; Department of Surgery, Division of CT Surgery, St. Joseph Health (L.P.), Mission Hospital, Mission Viejo, California; Department of Surgery, Division of Trauma, George Washington University (B.S.), Washington, District of Columbia; Department of Surgery, Division of Trauma, Wright State University/Miami Valley Hospital (G.S.), Dayton, Ohio; Department of Surgery, Division of Trauma, Carolinas Medical Center (B.T.), Charlotte, North Carolina; Department of Surgery, Division of Trauma, The Queens Medical Center (F.Z.), Honolulu, Hawaii; Department of Surgery, Division of Trauma, Sanford Health (C.D.), Fargo, North Dakota; Department of Surgery, Division of Trauma, Baystate Medical Center (A.R.D.), Springfield, Massachusetts.

Background: The efficacy of surgical stabilization of rib fracture (SSRF) in patients without flail chest has not been studied specifically. We hypothesized that SSRF improves outcomes among patients with displaced rib fractures in the absence of flail chest.

Methods: Multicenter, prospective, controlled, clinical trial (12 centers) comparing SSRF within 72 hours to medical management. Read More

Singapore Med J 2019 Dec 2. Epub 2019 Dec 2.

Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore.

Introduction: Many institutions still perform routine chest radiographs after tube thoracostomies despite current guidelines suggesting that this is not necessary for simple cases. We aimed to evaluate the usefulness of routine chest radiography following ultrasonography-guided catheter thoracostomies for the detection of complications of symptomatic pleural effusions in hospitalised patients.

Methods: This was a retrospective review of 2,032 ultrasonography-guided thoracostomies on hospitalised patients with symptomatic effusions at a single institution from April 2012 to May 2015. Read More

Am Surg 2019 Nov;85(11):1205-1208

Our department has a database of thoracic gunshot wounds (GSWs), which has cataloged these injury patterns over the past five decades. Prevailing wisdom on the management of these injuries suggested operative treatment beyond tube thoracostomy is not commonly required. It was our clinical impression that the operative treatment required beyond chest tube placement has greatly increased over the past several decades, whereas the operative management of cardiac GSWs seemed to be increasingly infrequent events. Read More

Clin Pract Cases Emerg Med 2019 Nov 21;3(4):327-328. Epub 2019 Oct 21.

Jigme Dorji Wangchuck National Referral Hospital, Department of Emergency Medicine, Thimphu, Bhutan.

A 33-year-old male was brought to the emergency department after a penetrating arrow injury to the chest. Initial evaluation revealed the arrow was penetrating the sternum, lung, and aortic arch. Because the patient was in a remote area, timely transfer to a specialized center for definitive operative repair was delayed approximately 24 hours. Read More

Am J Emerg Med 2019 Sep 11:158432. Epub 2019 Sep 11.

Cooper University Hospital, Cooper Medical School of Rowan University, Camden, NJ, Department of Emergency Medicine, United States of America.

Objective: It is unclear if additional computerized tomography (CT) imaging is warranted after injuries are identified on CT in blunt trauma patients. The objective of this study was to determine the incidence and significance of injuries identified on secondary CT imaging after identification of injuries on initial CTs in blunt trauma patients.

Methods: This was a retrospective cohort study at an academic Level 1 trauma center with a two-tiered trauma system. Read More

Medicine (Baltimore) 2019 Oct;98(43):e17397

Respiratory Medicine, Sir Charles Gairdner Hospital.

Background: Community-acquired pneumonia (CAP) is a major global disease. Parapneumonic effusions often complicate CAP and range from uninfected (simple) to infected (complicated) parapneumonic effusions and empyema (pus). CAP patients who have a pleural effusion at presentation are more likely to require hospitalization, have a longer length of stay and higher mortality than those without an effusion. Read More

Anaesth Crit Care Pain Med 2020 02 12;39(1):59-64. Epub 2019 Oct 12.

Fédération d'anesthésie-réanimation-brûlés-bloc opératoire, hôpital d'instruction des armées Percy, 101, avenue Henri Barbusse, 92140 Clamart, France; École du Val-de-Grâce, 75005 Paris, France. Electronic address:

Introduction: The current terrorist threat challenges nations to train numerous non-trauma care providers with different backgrounds in damage control (DC) strategies. The purpose of this work was to propose a specific DC training program.

Methods: A Task Force of 16 civilian and military physicians met for a 24-hour session, to propose the construction of a DC training program for non-specialised caregivers. Read More

Am J Surg 2019 12 21;218(6):1138-1142. Epub 2019 Sep 21.

University of Oklahoma Health Sciences Center, Department of Surgery, 800 Stanton L Young Blvd, Suite 9000, Oklahoma City, OK, 73104, USA. Electronic address:

Objective: This study examined the indications for prehospital needle thoracostomy (pNT), the need for tube thoracostomy (TT) following pNT, and the outcomes of patients who underwent pNT.

Methods: This study is a retrospective chart review of patients who underwent pNT prior to trauma center arrival. Patients were identified from the trauma registry and a quality improvement (QI) database from 9/2014-9/2018. Read More

Am Surg 2019 Aug;85(8):871-876

The aim of this study was to evaluate the impact of prehospital antiplatelet and/or anticoagulant (APAC) use on treatment and outcomes in patients with severe blunt chest injury. Patients with three or more rib fractures and a hospital length of stay (LOS) > three days admitted from 2014 to 2015 were included. Demographics, mortality, complications, injuries, hospital and ICU LOS, use of blood products, and thoracostomy were studied. Read More

Ann Thorac Surg 2019 12 27;108(6):e405-e407. Epub 2019 Aug 27.

Department of Cardiothoracic Surgery, University Hospital, Otto-von-Guericke-University, Magdeburg, Germany.

Chest tube thoracostomy is a standard procedure in every intensive care unit. Although it is regarded as a safe procedure in experienced hands, rare complications do occur. This report describes iatrogenic perforation of the left ventricle after placement of an intercostal catheter and the successful surgical management of this injury. Read More

High Alt Med Biol 2019 12 28;20(4):417-420. Epub 2019 Aug 28.

Department of Emergency Medicine, Alaska Native Medical Center, Anchorage, Alaska.

The care of victims of traumatic injuries requires an organized system to achieve the best outcomes. Dispatch of specialist physicians, paramedics, and nurses to the patient by helicopter can reduce mortality. Countries in the developing world share the challenge of providing timely medical care to trauma victims, while facing others such as a higher trauma burden, poor infrastructure, inadequate government resources, organizational constraints, a lack of technical expertise, and prohibitive costs. Read More

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

University of California, Irvine, Irvine, CA, USA.

Purpose: Whole-body computed tomography (CT) for blunt trauma patients is common. Chest CT (CCT) identifies "occult" pneumo- (PTX) and hemothorax (HTX) not seen on chest radiograph (CXR), one-third of whom get chest tubes, while CXR identifies "non-occult" PTX/HTX. To assess chest tube value for occult injury vs. Read More

Trauma Case Rep 2019 Aug 28;22:100210. Epub 2019 Jun 28.

Department of General Surgery, Division of Trauma and Acute Care Surgery, UC Davis Health, Sacramento, CA, United States of America.

Bean bag guns are considered "non-lethal" weapons used by law enforcement. There are emerging reports in the medical literature on management of penetrating, intrathoracic injuries and none were found that involve potential cardiac complications. We present a case of a penetrating bean bag involving the pericardium. Read More

J Surg Res 2019 12 10;244:225-230. Epub 2019 Jul 10.

Department of Surgery, Inova Fairfax Medical Campus, Falls Church, Virginia. Electronic address:

Background: Chest tube (CT) placement is among the most common procedures performed by trauma surgeons; evidence guiding CT management is limited and tends toward thoracic surgery patients. The study goal was to identify current CT management practices among trauma providers.

Materials And Methods: We designed a Web-based multiple-choice survey to assess CT management practices of trauma providers who were active, senior, or provisional members (n = 1890) of the Eastern Association for the Surgery of Trauma and distributed via e-mail. Read More

J Trauma Acute Care Surg 2019 07;87(1S Suppl 1):S128-S131

From InnoVital Systems and MedStar Emergency Physicians, (A.N.S.), InnoVital Systems, (C.S.K.), Calverton, Maryland; and Department of Radiology (S.D.), Thomas Jefferson University, Philadelphia, Pennsylvania.

Background: Multiple reports have detailed an unacceptably high error rate in the siting of decompression needles and tubes and describe associated iatrogenic injuries. The objective of the current study was to measure the accuracy of the novel ThoraSite template for identifying an acceptable intercostal space (ICS) for lateral needle or tube thoracostomy.

Methods: Two trained operators used the ThoraSite to place radiopaque needles in the left and right lateral chests of 12 cadavers. Read More

Ann Med Surg (Lond) 2019 Jul 25;43:25-28. Epub 2019 May 25.

Faculty of Medical Sciences, School of Medicine, Department Cardiothoracic and Vascular Surgery, University of Sulaimani, François Mitterrand Street, Sulaimani, Kurdistan Region, Iraq.

Introduction: Unilateral chest trauma has been perfectly described in the literature while bilateral chest trauma has never been specifically probed, the aim of this study is to highlight the specificities, presentations, the difference in the therapeutic algorithm and outcome of patients with bilateral thoracic trauma.

Patients And Methods: A single center, prospective study was carried out in four years. The data were taken directly from the patients, patient's relatives and the medical records. Read More

Trauma Surg Acute Care Open 2019 27;4(1):e000206. Epub 2019 Mar 27.

Surgery, University of Florida College of Medicine, Jacksonville, Florida, USA.

A 48-year-old man was admitted for medical management of recurrent (C-dif) colitis. One month prior to presentation, he underwent right thoracotomy and lower lobectomy for a carcinoid tumor at another hospital. His postoperative course was complicated by C-dif colitis, gastroesophageal reflux, and epigastric pain. Read More

Crit Care Med 2019 07;47(7):903-909

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Jacksonville, FL.

Objectives: Awareness of the impact of bedside ultrasound to reduce iatrogenic pneumothoraces while performing bedside pleural procedures has increased but with little understanding in how ultrasound is used for these procedures.

Design And Setting: We conducted a retrospective chart review at a tertiary referral center in the United States from January 1, 2014, to March 31, 2017. Our study assessed adverse effect rates between real-time ultrasound-guided and ultrasound-marked thoracenteses and thoracostomy tube placements. Read More

Medicine (Baltimore) 2019 Apr;98(14):e14993

Department of Thoracic Surgery.

Thoracic trauma in China was scarcely reported. This study aimed to summarize the clinical profiles and to analyze the management approaches of patients with traumatic thoracic injury.Data for consecutive patients with thoracic trauma from January 2003 to January 2018 were retrospectively collected and analyzed. Read More

J Trauma Acute Care Surg 2019 Mar 1. Epub 2019 Mar 1.

Department of Radiology, Thomas Jefferson University.

Background: Multiple reports have detailed an unacceptably high error rate in the siting of decompression needles and tubes and describe associated iatrogenic injuries. The objective of the current study was to measure the accuracy of the novel ThoraSite template for identifying an acceptable intercostal space (ICS) for lateral needle or tube thoracostomy.

Methods: Two trained operators used the ThoraSite to place radiopaque needles in the left and right lateral chests of 12 cadavers. Read More

Ann Ital Chir 2019 ;90:152-156

Introduction: Posttraumatic injuries are among the most frequent reasons of admission to emergency room services (ERs). In the first assessment of the cases, ATLS protocols recommends use of triage decision scheme consisting of parametres of abnormal physiologic findings, anatomic injury site, pathogenic mechanism of injury, concomitant diseases and conditions, and activation of trauma teams in line with these criteria. The aim of this study is to evaluate TEWS(Triage Early Warning Score) as a marker for predicting mortality in trauma patients who presented to Emergency Services. Read More

Cochrane Database Syst Rev 2019 02 1;2:CD011724. Epub 2019 Feb 1.

Department of Paediatrics, Lund University, Skåne University Hospital, Lund, Sweden.

Background: Pneumothorax occurs more frequently in the neonatal period than at any other time of life and is associated with increased mortality and morbidity. It can be treated with either aspiration with a syringe (using a needle or an angiocatheter) or a chest tube inserted in the anterior pleural space and then connected to a Heimlich valve or an underwater seal with continuous suction.

Objectives: To compare the efficacy and safety of needle aspiration (either with immediate removal of the needle or with the needle left in situ) to intercostal tube drainage in the management of neonatal pneumothorax (PTX). Read More

Int J Surg Case Rep 2019 19;55:47-49. Epub 2019 Jan 19.

Department of Surgery, King Fahad Hospital of the University, Collage of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia. Electronic address:

Introduction: Primary spontaneous hemopneumothorax (PSHP) is an accumulation of blood and air in the pleural space without trauma or obvious etiology. It is a rare surgical emergency and may lead to hypovolemic shock if not treated. Early and fast recognition will improve patient outcomes. Read More

World J Radiol 2018 Dec;10(12):184-189

Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, PA 17822, United States.

Aim: To investigate the hemothorax size for which tube thoracostomy is necessary.

Methods: Over a 5-year period, we included all patients who were admitted with blunt chest trauma to our level 1 trauma center. Focus was placed on identifying the hemothorax size requiring tube thoracostomy. Read More

J Trauma Acute Care Surg 2019 04;86(4):557-564

From the Division of Trauma, Critical Care, and Acute Care Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI.

Background: As more pneumothoraxes (PTX) are being identified on chest computed tomography (CT), the empiric trigger for tube thoracostomy (TT) versus observation remains unclear. We hypothesized that PTX measuring 35 mm or less on chest CT can be safely observed in both penetrating and blunt trauma mechanisms.

Methods: A retrospective review was conducted of all patients diagnosed with PTX by chest CT between January 2011 and December 2016. Read More

JFMS Open Rep 2018 Jul-Dec;4(2):2055116918817385. Epub 2018 Dec 3.

Dick White Referrals, Six Mile Bottom, UK.

Case Summary: A 2-year-old female neutered domestic shorthair cat was presented for investigation of acute onset tachypnoea and dyspnoea. Pyothorax was diagnosed based on thoracic radiographs and fluid analysis. Medical treatment consisted of bilateral thoracostomy tube placement, antibiotic therapy and thoracic lavage. Read More

Am J Case Rep 2018 Dec 3;19:1434-1436. Epub 2018 Dec 3.

Department of Internal Medicine, Wayne State University, Rochester Hills, MI, USA.

BACKGROUND Lymphatic circulation in the thorax enters the systemic blood flow at the subclavian vein. Instances where diversion occurs leads to complications such as pleural effusion. A rare complication of lymphatic diversion results in fluid accumulation in the bronchial tree, causing plastic bronchitis. Read More

Am J Emerg Med 2019 01 24;37(1):173.e1-173.e2. Epub 2018 Sep 24.

University of Utah Health, USA.. Electronic address:

Spontaneous pneumothorax (SP) is a relatively common pathology in emergency medicine; however, scant information is published regarding SPs developing tension physiology in the literature. Risk factors for spontaneous pneumothorax include smoking, family history, and underlying lung disease such as chronic obstructive lung disease (COPD), cystic fibrosis, tuberculosis, among others. Treatment often involves conservative management, needle aspiration, catheter placement, or tube thoracostomy. Read More

Am J Emerg Med 2019 02 26;37(2):377.e5-377.e6. Epub 2018 Oct 26.

University of South Florida, Lehigh Valley Medical Center, Allentown, PA 18103, United States of America.

Thoracostomy tube placement is one of the more common procedures performed in the Emergency Department, most commonly for treatment of pneumothorax or hemothorax but occasionally for drainage of empyema or pleural effusion. Thoracostomy may be a life-saving procedure with a wide range of complication rates reported, ranging from 19.4-37%, most commonly extrathoracic placement. Read More

Vet Surg 2018 Nov 10;47(8):1046-1051. Epub 2018 Oct 10.

Dick White Referrals, Six Mile Bottom, Newmarket, United Kingdom.

Objective: To describe and compare fluoroscopic guidance for placement of wide-bore thoracostomy tubes (FGTT) to traditional, blind placement of thoracostomy tubes (BPTT).

Study Design: Prospective clinical trial.

Animals: Twenty client-owned dogs. Read More

Ann R Coll Surg Engl 2018 Oct 5:1-9. Epub 2018 Oct 5.

Department of Surgery, University of KwaZulu Natal , Durban , South Africa.

Introduction: Penetrating thoracic trauma is common and costly. Injuries are frequently and selectively amenable to non-operative management. Our selective approach to penetrating thoracic trauma is reviewed and the effectiveness of our clinical algorithms confirmed. Read More

J Surg Res 2018 11 30;231:15-23. Epub 2018 May 30.

Department of Epidemiology & Biostatistics, University of Texas Health Science Center at San Antonio, San Antonio, Texas.

Background: Chest tube management protocols, particularly in patients with alveolar-pleural air leak due to recent surgery or trauma, are limited by concerns over safety, especially concerns about rapid and occult development of pneumothorax. A continuous, real-time monitor of pneumothorax could improve the quality and safety of chest tube management. We developed a rat model of pneumothorax to test a novel approach of measuring electrical impedance within the pleural space as a monitor of lung expansion. Read More

Am Surg 2018 Sep;84(9):1480-1483

Routine full-body CT "pan-scan" use in older patients after ground level falls (GLFs) is of questionable benefit. Retrospective review of new diagnosis & changes in management in patients >55 years with Glasgow Coma Scale of 15 after a GLF who received a pan-scan (routine head, cervical spine/neck, chest abdomen, and pelvis CT). Head CT results were considered separately; results described in the following paragraph pertains to cervical spine/neck, chest, abdomen, and pelvis CT. Read More

J Infect Dev Ctries 2018 09 30;12(9):748-754. Epub 2018 Sep 30.

Faculty of Medicine, Trakya University, Edirne,Turkey.

Introduction: Descending Necrotizing Mediastinitis (DNM) is the fatal form of mediastinitis and mostly develops as a complication of peritonsillar abscesses or dental-odontogenic infections. The aim of this study is to evaluate clinical and surgical feature of the patients with DNM who were managed in our clinic.

Methodology: We retrospectively evaluated 13 consecutive patients with the diagnosis of DNM between February 2005 and February 2018. Read More