Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Aug 2011
The value of clinical examination in diagnosing pelvic fractures in blunt trauma patients: a brief review.
To evaluate the value of a pelvic X-ray compared to clinical examination in diagnosing pelvic ring fractures, using computed tomography (CT) as the gold standard, in alert [Glasgow Coma Scale (GCS) ≥ 13] adult blunt trauma patients in the emergency room. ⋯ In alert blunt trauma patients, pelvic X-ray only has additional diagnostic value for the detection of pelvic ring fractures if the clinical examination is positive. Pelvic X-ray should not be performed if the clinical examination is negative. In this manner, the expenditure of time, costs, and radiation are optimized.
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Eur J Trauma Emerg S · Aug 2011
Therapeutic and interventional endoscopy for gastrointestinal bleeding.
Gastrointestinal (GI) bleeding remains a common clinical problem encountered by every emergency room and trauma physician. Endoscopy remains the main approach to the diagnosis and therapy of GI bleeding. ⋯ This is the first review paper dedicated to endoscopic therapy for bleeding involving any part of the luminal GI tract (i.e., esophagus, stomach, small bowel, and colon). Modern endoscopy permits the investigation and treatment of the majority of conditions affecting the entire hollow GI tract.
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Eur J Trauma Emerg S · Aug 2011
Prediction of immediate and long-term benefit after kyphoplasty of painful osteoporotic vertebral fractures by preoperative MRI.
It is unclear if an MR-detectable bone marrow edema is a prerequisite for pain reduction and morphological correction by kyphoplasty. This comparative trial evaluates clinical and radiomorphological outcomes after kyphoplasty of painful osteoporotic vertebral fractures with and without preoperative MR-detectable bone marrow edema for 1 year of follow-up. ⋯ A preoperative MR-detectable vertebral bone marrow edema predicts a better short-term outcome after kyphoplasty, but is not a prerequisite for long-term pain reduction in patients with old, chronically painful osteoporotic vertebral fractures.
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Eur J Trauma Emerg S · Aug 2011
Radiographic techniques for the localization and treatment of gastrointestinal bleeding of obscure origin.
Acute gastrointestinal bleeding (GIB) is an emergency with high mortality rates, which requires a quick localization and treatment of the bleeding site. In this article, we give a summary of the diagnostic and interventional treatment of acute GIB with an emphasis on radiological methods. ⋯ Managing obscure acute GIB remains a challenge. The best patient care is achieved with a multidisciplinary team of endoscopists, experienced surgeons, and interventional radiologists. If emergency endoscopy fails, a CTA has to be done, which is more sensitive than conventional angiography. Based on CTA findings, a decision must be made between TAE and surgical intervention.